Basic Information
| Provider Information | |||||||||
| NPI: | 1538498159 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | LAWRENCE E. BURNS, DPM, INC | ||||||||
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| OtherOrganizationName: | DR. LAWRENCE E BURNS, DPM | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 104 WOODMONT BLVD | ||||||||
| Address2: | SUITE LL50 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372052245 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153862300 | ||||||||
| FaxNumber: | 6153862399 | ||||||||
| Practice Location | |||||||||
| Address1: | 4230 HARDING RD | ||||||||
| Address2: | SUITE G-12 | ||||||||
| City: | NASHVILLE | ||||||||
| State: | TN | ||||||||
| PostalCode: | 372052013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6153017054 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 12/10/2009 | ||||||||
| LastUpdateDate: | 12/10/2009 | ||||||||
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| AuthorizedOfficialLastName: | BURNS | ||||||||
| AuthorizedOfficialFirstName: | LAWRENCE | ||||||||
| AuthorizedOfficialMiddleName: | E | ||||||||
| AuthorizedOfficialTitleorPosition: | SOLE PROPRIETOR | ||||||||
| AuthorizedOfficialTelephone: | 6153862300 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | DPM | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 332BC3200X | 0531 DPM | TN | N | Suppliers | Durable Medical Equipment & Medical Supplies | Customized Equipment | 335E00000X | 0531 DPM | TN | Y | Suppliers | Prosthetic/Orthotic Supplier |
ID Information
| ID | Type | State | Issuer | Description | TN0173 | 01 | TN | AMERICHOICE MCD | OTHER | 01040363 | 01 | TN | AMERIGROUP MCD & MCR ADVANTAGE | OTHER | 1104535 | 01 | TN | WINDSOR MEDICARE ADVANTAGE | OTHER | 7100042140 | 05 | KY | MEDICAID | 3353057 | 05 | TN | MEDICAID | 480029698 | 01 | TN | MEDICARE RAILROAD | OTHER | 173095 | 01 | TN | DOL FECA | OTHER | 4389487 | 01 | TN | AETNA | OTHER | 3146270 | 01 | TN | BLUE CROSS OF TN | OTHER | 344395 | 01 | TN | USA MANAGED CARE | OTHER | 2226259 | 01 | TN | CIGNA | OTHER |