Provider Demographics
NPI:1285996694
Name:BURKETT, ELIZABETH ANDERSON (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANDERSON
Last Name:BURKETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:MARIE
Other - Last Name:ANDERSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:124 S UNIVERSITY BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-3078
Mailing Address - Country:US
Mailing Address - Phone:251-343-5004
Mailing Address - Fax:251-343-8383
Practice Address - Street 1:124 S UNIVERSITY BLVD STE A
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-3078
Practice Address - Country:US
Practice Address - Phone:251-343-5004
Practice Address - Fax:251-343-8383
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-12
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC183355207R00000X
ALMD.35714207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALMD.35714OtherAL LICENSE