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Individual

BARRY DEAN BERTOLET

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
499 GLOSTER CREEK VILLAGE A-2, CARDIOLOGY ASSOCIATES OF N. MS, PA, TUPELO, MS 38801
(662) 620-6800
(662) 620-6950
Mailing address
499 GLOSTER CREEK VLG STE A2, CARDIOLOGY ASSOCIATES OF N. MS, PA, TUPELO, MS 38801-4749
(662) 620-6800
(662) 620-6950

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
11333
MS
207RI0011X
Interventional Cardiology Physician
11333
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0118728
MS
Enumeration date
08/30/2006
Last updated
08/02/2013
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