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Shannon M. Burgess, Od
Medical Specialty Clinic/Center in Phoenixville, Pennsylvania
NPI 1275835829

Shannon M. Burgess, Od is a Medical Specialty Clinic/Center based in Phoenixville, PA and is specialized in Medical Specialty. Shannon M. Burgess, Od practices in Phoenixville, PA. The NPI Number for Shannon M. Burgess, Od is 1275835829 and holds a License No. OEG000127 (Pennsylvania).

The current practice location address for Shannon M. Burgess, Od is 1260 Valley Forge Rd, Phoenixville, PA and can be reached out via phone at 610-917-0700 and via fax at 610-917-0708.

Location: 1260 Valley Forge Rd, Phoenixville, PA, 19460-2691
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1275835829
Provider Name
Shannon M. Burgess, Od
Credential
Provider Entity Type
Organization
Address
1260 Valley Forge Rd, Phoenixville, PA, 19460-2691
Phone Number
610-917-0700
Fax Number
610-917-0708
Provider Enumeration Date
12/01/2010
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2013716000 01 KEYSTONE HEALTH PLAN
001321149 01 BLUE SHIELD
50004981 01 CAPITAL BLUE CROSS
institution
Provider Business Practice Location Address Details
Address
1260 Valley Forge Rd
City
Phoenixville
State
Pennsylvania
Zip
19460-2691
Phone Number
610-917-0700
Fax Number
610-917-0708
person
Provider Business Mailing Address Details
Address
1260 Valley Forge Rd
City
Phoenixville
State
Pennsylvania
Zip
19460-2691
Phone Number
610-917-0700
Fax Number
610-917-0708
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Medical Specialty
Taxonomy
261QM2500X
License No.
OEG000127 (Pennsylvania)
Definition
An entity, facility, or distinct part of a facility providing diagnostic, treatment, and prescriptive services related to a specific area of medical specialization. Frequently used for Title V related Children's Specialty services or to meet specific public health needs (e.g., infectious diseases or breast and cervical cancer).
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