Provider Demographics
NPI:1063528081
Name:BURNEY, BRIAN SCOTT (RPH)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:SCOTT
Last Name:BURNEY
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:168 S PAYNE STEWART DR STE 150
Mailing Address - Street 2:
Mailing Address - City:BRANSON
Mailing Address - State:MO
Mailing Address - Zip Code:65616-2709
Mailing Address - Country:US
Mailing Address - Phone:417-527-0585
Mailing Address - Fax:844-476-0043
Practice Address - Street 1:168 S PAYNE STEWART DR STE 150
Practice Address - Street 2:
Practice Address - City:BRANSON
Practice Address - State:MO
Practice Address - Zip Code:65616-2709
Practice Address - Country:US
Practice Address - Phone:417-527-0585
Practice Address - Fax:844-476-0043
Is Sole Proprietor?:No
Enumeration Date:2006-08-22
Last Update Date:2025-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO43734183500000X
MO043734183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO600159792Medicaid
MO43734OtherSTATE PHARMACIST LICENSE