Provider Demographics
NPI:1023286051
Name:BURNS, LANCE KYLE (MD)
Entity type:Individual
Prefix:DR
First Name:LANCE
Middle Name:KYLE
Last Name:BURNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:701 N UNIVERSITY AVE
Mailing Address - Street 2:SUITE 203
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-2936
Mailing Address - Country:US
Mailing Address - Phone:501-664-2434
Mailing Address - Fax:501-907-7768
Practice Address - Street 1:701 N UNIVERSITY AVE
Practice Address - Street 2:SUITE 203
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-2936
Practice Address - Country:US
Practice Address - Phone:501-664-2434
Practice Address - Fax:501-907-7768
Is Sole Proprietor?:No
Enumeration Date:2008-02-12
Last Update Date:2016-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-6578208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR186828001Medicaid
AR5AF19Medicare UPIN