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Individual

KATHERINE A BERTRAM

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
128 N WHITNEY AVE, COOKEVILLE, TN 38501-2493
(931) 783-4600
(931) 783-4699
Mailing address
128 N WHITNEY AVE, COOKEVILLE, TN 38501-2493
(931) 783-5999
(931) 783-5898

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
20230
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1511233
TN
05
3051927
TN
05
3723270
TN
05
PENDING
TN
Enumeration date
09/02/2005
Last updated
06/29/2020
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