Individual
KENNETH R BERNARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
167 NORTH MAIN STREET, TUBA CITY, AZ 86045-0600
(928) 283-2094
(928) 283-2677
Mailing address
PO BOX 600, TUBA CITY, AZ 86045-0600
(928) 283-2094
(928) 283-2677
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
0101271578
VA
207P00000X
Emergency Medicine Physician
Primary
51295
AZ
390200000X
Student in an Organized Health Care Education/Training Program
—
MA
Other
Enumeration date
03/25/2011
Last updated
07/22/2021
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