DR. DERRICK BURGESS (NPI# 1720244932) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720244932 |
| Entity Type | Individual |
| Full Name | DR. DERRICK BURGESS |
| Credential | M.D. |
| Practice Address |
1002 Jefferson St. Suite 350 Laurel MS 39440-4306 |
| Mailing Address |
Po Box 247 Laurel MS 39441-0247 |
| Practice Telephone | 6016495990 |
| Practice Fax Number | 6013996281 |
| Mailing Telephone | 6013996167 |
| Mailing Fax Number | 6013996281 |
| Enumeration Date | 2008-08-06 |
| Last Update Date | 2020-01-06 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207X00000X | Orthopaedic Surgery | 23260 | MS | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 45479 | KY | Allopathic & Osteopathic Physicians |
| N | 207X00000X | Orthopaedic Surgery | 35.099675 | OH | Allopathic & Osteopathic Physicians |
| Street Address |
1002 JEFFERSON ST. SUITE 350 |
| City | LAUREL |
| State | MS |
| Zip Code | 39440-4306 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932233392 | Jens Francis Graversen | Urology | 1002 Jefferson St., Suite 450, Laurel, MS 39440-4306 | 2007-03-15 |
| 1316359789 | Terry L. Bang | Pediatrics | 1002 Jefferson St., Suite 200, Laurel, MS 39440-4306 | 2014-05-20 |
| 1790988087 | Charles Henry Black Iv | Orthopaedic Surgery | 1002 Jefferson St., Suite 350, Laurel, MS 39440-4306 | 2007-06-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306323159 | Tender Loving Care Homecare LLC | Homemaker | 509 Central Ave Ste 224, Laurel, MS 39440 | 2018-07-24 |
| 1669837910 | Laurel Dental Properties | Dentist | 1925 Pine Belt Drive, Laurel, MS 39440 | 2015-12-30 |
| 1215282991 | South Central Regional Medical Center | Clinic/Center | 525 Wayne Drive, Laurel, MS 39440 | 2012-07-18 |
| 1568721215 | Terry Ratcliff Perkins | Counselor | 5192 Hwy 11 North, Laurel, MS 39440 | 2012-05-15 |
| 1437453057 | Alexander Milne Home for Women | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 616 East 19th Street, Laurel, MS 39440 | 2010-12-23 |
| 1710135629 | Jeffrey R. Moffett | Nurse Practitioner | 3115 Audubon Dr, Laurel, MS 39440 | 2008-09-04 |
| 1003096785 | Family Health Center, Inc | Obstetrics & Gynecology | 103 S. 12th Avenue, Laurel, MS 39440 | 2007-11-09 |
| 1669672143 | Laurel Urology Clinic Pa | Urology | 304 S 10th Ave, Laurel, MS 39440 | 2007-07-23 |
| 1093912370 | Tanweer Hussain Majid | Surgery | 1007 Jefferson Street, Laurel, MS 39440 | 2007-06-29 |
| 1780889923 | Hattiesburg Eye Clinic, Pa | Ophthalmology | 1431 North 10th St, Suite 1, Laurel, MS 39440 | 2007-06-18 |
| Find all providers in zip 39440 | ||||
| Taxonomy Code | 207X00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Orthopaedic Surgery |
| An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Orthopaedic Surgery, 2007. http://www.abos.org/. American Osteopathic Board of Orthopaedic Surgery, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Orthopaedic Surgery. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Orthopaedic Surgery. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760530349 | Harvinder S Pabla | Orthopaedic Surgery | 14333 Laurel Bowie Rd Ste 209, Laurel, MD 20708-1179 | 2007-01-08 |
| 1306815907 | Steven Douglas Nowicki | Orthopaedic Surgery | 1002 Jefferson Street, Suite 350, Laurel, MS 39440-4306 | 2006-03-16 |
| 1558330415 | Thomas Harold Blake Jr. | Orthopaedic Surgery | 424 S 13th Ave, Laurel, MS 39440-4345 | 2006-03-14 |
| 1154760833 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 14201 Laurel Park Drive, Suite 111, Laurel, MD 20707 | 2013-06-17 |
| 1841635034 | Southern Bone & Joint Specialists, Pa | Orthopaedic Surgery | 30 Circle J Dr, #1, Laurel, MS 39440-1980 | 2013-05-02 |
| 1265615249 | South Central Clinics, Inc | Orthopaedic Surgery | 1002 Jefferson Street, Suite 350, Laurel, MS 39440-4306 | 2007-12-12 |
| 1265614820 | H.s. Pabla, M.d., P.C. | Orthopaedic Surgery | 14333 Laurel Bowie Rd, Laurel, MD 20708-1126 | 2007-12-05 |
| 1790988087 | Charles Henry Black Iv | Orthopaedic Surgery | 1002 Jefferson St., Suite 350, Laurel, MS 39440-4306 | 2007-06-06 |
| 1841407962 | Viener Orthopedics, P.a. | Orthopaedic Surgery | 7350 Van Dusen Rd, Suite 110, Laurel, MD 20707-5263 | 2007-05-17 |
| 1518096239 | Premier Orthopedics, P.a. | Orthopaedic Surgery | 545 Main St, Suite 217, Laurel, MD 20707-4351 | 2007-03-06 |
| Find all providers in LAUREL | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.