Basic Information
| Provider Information | |||||||||
| NPI: | 1740418631 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BURGIN | ||||||||
| FirstName: | AARON | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 3488 | ||||||||
| Address2: | DEPT 05-045 | ||||||||
| City: | TUPELO | ||||||||
| State: | MS | ||||||||
| PostalCode: | 388033488 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8446990011 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2600 GREENWOOD RD | ||||||||
| Address2: | |||||||||
| City: | SHREVEPORT | ||||||||
| State: | LA | ||||||||
| PostalCode: | 711033908 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3182124000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/30/2009 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 390200000X | 4301095088 | MI | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 2085R0202X | MD207772 | LA | Y | Allopathic & Osteopathic Physicians | Radiology | Diagnostic Radiology |
No ID Information.