Provider Demographics
NPI:1063598373
Name:BURGESS, BERNARD L JR (MD)
Entity type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:L
Last Name:BURGESS
Suffix:JR
Gender:M
Credentials:MD
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Mailing Address - Street 1:4601 CAROTHERS PKWY
Mailing Address - Street 2:SUITE 360
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5976
Mailing Address - Country:US
Mailing Address - Phone:615-794-8900
Mailing Address - Fax:615-794-0038
Practice Address - Street 1:3601 SW 160TH AVE
Practice Address - Street 2:SUITE 250
Practice Address - City:MIRAMAR
Practice Address - State:FL
Practice Address - Zip Code:33027-6308
Practice Address - Country:US
Practice Address - Phone:954-399-4645
Practice Address - Fax:855-855-2792
Is Sole Proprietor?:No
Enumeration Date:2006-10-29
Last Update Date:2016-10-18
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000025546208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2580466-009OtherCIGNA HEALTHCARE
TN1740257OtherUNITED HEALTHCARE
TN3083796Medicaid
TN3021125OtherBCBS
TN681986OtherAETNA
TN3021125OtherBCBS
TN681986OtherAETNA
TNF84774Medicare UPIN