Provider Demographics
NPI:1932173259
Name:BURNS, GLORIA ANN (MD)
Entity type:Individual
Prefix:DR
First Name:GLORIA
Middle Name:ANN
Last Name:BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8914 DOE TRAIL CV S
Mailing Address - Street 2:
Mailing Address - City:CORDOVA
Mailing Address - State:TN
Mailing Address - Zip Code:38018-7607
Mailing Address - Country:US
Mailing Address - Phone:870-623-5107
Mailing Address - Fax:901-757-7789
Practice Address - Street 1:8914 DOE TRAIL CV S
Practice Address - Street 2:
Practice Address - City:CORDOVA
Practice Address - State:TN
Practice Address - Zip Code:38018-7607
Practice Address - Country:US
Practice Address - Phone:870-623-5107
Practice Address - Fax:901-757-7789
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2019-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2618207Q00000X
ARE-2618207P00000X
TNMD0000034409207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1414533001Medicaid
ARH25154Medicare UPIN
AR5L613Medicare ID - Type Unspecified