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Contact Information

CONNOR BURNSIDE, DO
2080 MEADOWLAND PARK BLVD
LAKELAND, FL33803-4326
 Phone: 863-701-2470
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Psychiatry

2084P0805X 86 Physician/Neuropsychiatry
Indicates primary specialty

NPI Profile & details for CONNOR BURNSIDE · (Male)

NPI Number 1922595990
Status Active
Credentials DO (Doctor of Osteopathic)
Entity Individual
Enumeration date 04/16/2018
Last updated 09/10/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • FL License # OS18828
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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