Dr. Roger Grady Burrus, M.D.
Specialist in Hendersonville, TN. Individual provider (NPI-1).
NPI number1114912656
StatusActive
Last updated in NPPESOct 30, 2015
Details
- NPI
- 1114912656
- Entity type
- Individual (NPI-1)
- Name
- Dr. Roger Grady Burrus
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Sep 12, 2005
- Last updated
- Oct 30, 2015
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 174400000X | Specialist | 20833 | TN | Yes |
Practice location
123 Fairways DrHendersonville, TN 37075-2610
Phone 615-969-2131
Mailing address
323 Steam Plant RdGallatin, TN 37066-3025
Phone 615-452-1060 · Fax 615-452-5474
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