Individual
DR. JERRY RUSSELL BARTLESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7434 SONG LAKE RD, TULLY, NY 13159-9211
(315) 569-6329
(315) 696-5539
Mailing address
7434 SONG LAKE RD, TULLY, NY 13159-9211
(315) 569-6329
(315) 696-5539
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
163749
NY
207P00000X
Emergency Medicine Physician
28860
WI
207P00000X
Emergency Medicine Physician
31435
MN
207P00000X
Emergency Medicine Physician
MD446096
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
163749
—
NY
05
—
31522700
—
WI
05
—
981088900
—
MN
Enumeration date
06/12/2006
Last updated
01/26/2026
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