Provider Demographics
NPI:1386135978
Name:BURKE, MATTHEW DOWNING
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:DOWNING
Last Name:BURKE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4882 MISTY RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38135-1134
Mailing Address - Country:US
Mailing Address - Phone:901-385-8193
Mailing Address - Fax:
Practice Address - Street 1:628 HIGHWAY 51 N
Practice Address - Street 2:
Practice Address - City:RIPLEY
Practice Address - State:TN
Practice Address - Zip Code:38063-5904
Practice Address - Country:US
Practice Address - Phone:731-635-5582
Practice Address - Fax:731-635-5489
Is Sole Proprietor?:No
Enumeration Date:2018-05-20
Last Update Date:2018-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN8509183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist