Provider Demographics
NPI:1053608224
Name:BURNS, CASSIE KENNEDY (MD)
Entity type:Individual
Prefix:
First Name:CASSIE
Middle Name:KENNEDY
Last Name:BURNS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 MOBILE INFIRMARY CIR STE 410
Mailing Address - Street 2:
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36607-3512
Mailing Address - Country:US
Mailing Address - Phone:251-435-6850
Mailing Address - Fax:
Practice Address - Street 1:3 MOBILE INFIRMARY CIR STE 410
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36607-3512
Practice Address - Country:US
Practice Address - Phone:251-435-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-07
Last Update Date:2020-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.10744207L00000X
MST-2413207L00000X
ALMD.35120207LP2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain Medicine
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL187865Medicaid