Bertram, Phillip D

Bertram, Phillip D is an individual health care provider with primary practice located at 438 N Whitney Ave , Cookeville TN 38501-2455. He recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as his primary health care specialty. Bertram, Phillip D can be contacted via phone (931) 783-2616.

Contact Information

Primary practice address
438 N Whitney Ave Cookeville TN 38501-2455
Phone: (931) 783-2616
Fax: (931) 783-2610
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gastroenterology 207RG0100X 6496 Tennessee

Profile Details

NPI number 1487648507
LBN Legal business name Bertram, Phillip D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 2nd, 2005
Last updated May 26th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1487648507 NPPES
Tennessee Other 4212762 BCBS
Tennessee MEDICAID 3154324 BCBS
Tennessee MEDICAID 64790702 BCBS

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