Individual
DR. JAMES TODD BERGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
141 HOSPITAL DR, SALEM, KY 42078-8043
(270) 988-3298
(270) 988-4642
Mailing address
PO BOX 347, SALEM, KY 42078-0347
(270) 988-3298
(270) 988-4642
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
35724
KY
208600000X
Surgery Physician
Primary
35724
KY
208D00000X
General Practice Physician
35724
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000797438
ANTHEM BLUE CROSS & BLUE SHIELD
KY
05
—
64016157
—
KY
Enumeration date
04/10/2006
Last updated
01/10/2013
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