Provider Demographics
NPI:1295872943
Name:BURNS, ELDRIDGE G JR (MD)
Entity type:Individual
Prefix:
First Name:ELDRIDGE
Middle Name:G
Last Name:BURNS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:E.
Other - Middle Name:GENE
Other - Last Name:BURNS
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:300 N COLUMBIA AVE
Mailing Address - Street 2:
Mailing Address - City:SEWARD
Mailing Address - State:NE
Mailing Address - Zip Code:68434-2299
Mailing Address - Country:US
Mailing Address - Phone:402-646-4628
Mailing Address - Fax:402-646-4605
Practice Address - Street 1:300 N COLUMBIA AVE
Practice Address - Street 2:
Practice Address - City:SEWARD
Practice Address - State:NE
Practice Address - Zip Code:68434-2299
Practice Address - Country:US
Practice Address - Phone:402-646-4628
Practice Address - Fax:402-646-4605
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2025-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101246831207Q00000X
TNMD25420207Q00000X
LA10477R208D00000X
TXP1277207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
F89261Medicare UPIN
TX458867Medicare UPIN