Individual
RONALD BERTRAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 NW A ST, BENTONVILLE, AR 72712-3985
(479) 268-3050
(479) 273-0050
Mailing address
PO BOX 550, LOWELL, AR 72745-0550
(479) 463-7775
(479) 463-7187
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E3360
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
148406001
—
AR
Enumeration date
06/04/2006
Last updated
12/31/2013
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