Provider Demographics
NPI:1053424887
Name:BURRIS, JOSEPH W JR (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:W
Last Name:BURRIS
Suffix:JR
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2585 WAHO ST
Mailing Address - Street 2:
Mailing Address - City:KOLOA
Mailing Address - State:HI
Mailing Address - Zip Code:96756-9550
Mailing Address - Country:US
Mailing Address - Phone:808-346-3324
Mailing Address - Fax:
Practice Address - Street 1:2585 WAHO ST
Practice Address - Street 2:
Practice Address - City:KOLOA
Practice Address - State:HI
Practice Address - Zip Code:96756-9550
Practice Address - Country:US
Practice Address - Phone:808-346-3324
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-16
Last Update Date:2016-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA94008207P00000X
HI14727207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine