Individual
JEFFREY K BERT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2699 N 17TH ST, COOS BAY, OR 97420-2134
(541) 266-3600
(541) 269-0708
Mailing address
2699 N 17TH ST, COOS BAY, OR 97420-2134
(541) 266-3600
(541) 269-0708
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
MD09764
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050922009
BLUE CROSS
—
01
—
200025535
RAILROAD MEDICARE
—
05
—
240218
—
OR
01
—
97420A010
TRICARE
—
01
—
C105001
PACIFIC SOURCE
—
Enumeration date
05/30/2006
Last updated
07/06/2010
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