Individual
DR. RONALD ALLEN BERRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2211 MAYFAIR DR, SUITE 301, OWENSBORO, KY 42301-4572
(270) 688-4430
(270) 688-4439
Mailing address
PO BOX 23229, OWENSBORO, KY 42304-3229
(270) 688-4430
(270) 688-4439
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
22811
KY
208D00000X
General Practice Physician
22811
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000521567
BCBS
KY
05
—
64228117
—
KY
Enumeration date
05/04/2006
Last updated
06/13/2014
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