Individual
DR. BERNHARD ERIC DIETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
116 W MAIN ST, HENDERSON, TN 38340-2231
(731) 824-2400
(731) 824-0388
Mailing address
116 W MAIN ST, HENDERSON, TN 38340-2231
(731) 989-0001
(731) 520-0064
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
27623
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3077257
BC/BS OF TENNESSEE
TN
05
—
3818356
—
TN
01
—
5572559
AETNA
TN
01
—
7864
TLC-MEMPHIS MANAGED CARE
TN
01
—
80121733
METRAHEALTH
TN
Enumeration date
06/13/2005
Last updated
02/10/2021
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