Provider Demographics
NPI:1841292703
Name:BURKE, JAMES S JR (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:S
Last Name:BURKE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1050 OLD DES PERES RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63131-1873
Mailing Address - Country:US
Mailing Address - Phone:314-569-0612
Mailing Address - Fax:314-966-0664
Practice Address - Street 1:1050 OLD DES PERES RD
Practice Address - Street 2:SUITE 100
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63131-1873
Practice Address - Country:US
Practice Address - Phone:314-569-0612
Practice Address - Fax:314-966-0664
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2021-03-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MOR7N93207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO9168280OtherCIGNA
MO0900195OtherUNITED HEALTHCARE
MO274019OtherHEALTHLINK
MO16727OtherANTHEM
MO200040327OtherMEDICARE RAILROAD
MO4633698OtherAETNA
MO63352OtherCOVENTRY
MO16727OtherANTHEM
MO4208030001Medicare NSC
MO4633698OtherAETNA