Basic Information
| Provider Information | |||||||||
| NPI: | 1730195421 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | DONALD C. BURR RADIOLOGIST | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 289 | ||||||||
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| City: | NASHVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622630289 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 101 N WALNUT ST | ||||||||
| Address2: | |||||||||
| City: | PINCKNEYVILLE | ||||||||
| State: | IL | ||||||||
| PostalCode: | 622741034 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6183572187 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2006 | ||||||||
| LastUpdateDate: | 04/15/2008 | ||||||||
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| AuthorizedOfficialLastName: | SPENCE | ||||||||
| AuthorizedOfficialFirstName: | SHARON | ||||||||
| AuthorizedOfficialMiddleName: | D | ||||||||
| AuthorizedOfficialTitleorPosition: | BILLING ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8148649932 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MRS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2085R0202X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.