Provider Demographics
NPI:1871532903
Name:BURKE, JAMES J II (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:J
Last Name:BURKE
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:4700 WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6220
Mailing Address - Country:US
Mailing Address - Phone:912-350-8619
Mailing Address - Fax:912-350-3932
Practice Address - Street 1:4700 WATERS AVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31404-6220
Practice Address - Country:US
Practice Address - Phone:912-350-8619
Practice Address - Fax:912-350-3932
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2022-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA045737207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000806484HMedicaid
SCG55098Medicaid
GA000806484DMedicaid
GA000806484CMedicaid
GA349730OtherWELLCARE
GAP00679488OtherRAILROAD MEDICARE
GAP01102316OtherRAILROAD MEDICARE
GA000806484GMedicaid
GA000806484EMedicaid
01273389OtherAMERIGROUP
GA000806484FMedicaid
GA98BBBBRMedicare PIN
GA511I980003Medicare PIN
GA000806484EMedicaid