Basic Information
Provider Information
NPI: 1225490253
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURKEEN
FirstName: CHRISTOPHER
MiddleName: GRANT
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 800 ROSE ST
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360093
CountryCode: US
TelephoneNumber: 8593231786
FaxNumber: 8592577715
Practice Location
Address1: 800 ROSE ST
Address2:  
City: LEXINGTON
State: KY
PostalCode: 405360298
CountryCode: US
TelephoneNumber: 8593236762
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/29/2016
LastUpdateDate: 07/11/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RH0003X52528KYY Allopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology

No ID Information.


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