Individual
JEFFREY SCOTT BERTHOT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
4800 NE STALLINGS DR, SUITE 110, NACOGDOCHES, TX 75965-1249
(936) 569-9443
Mailing address
4800 NE STALLINGS DR, SUITE 110, NACOGDOCHES, TX 75965-1249
(936) 569-9443
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA04204
TX
Other
Enumeration date
10/03/2006
Last updated
06/02/2010
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