Healthcare Provider Details

I. General information

NPI: 1366536237
Provider Name (Legal Business Name): BERNIE NORMAN SERGENT DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2006
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 CROSSFIELD DR STE B
VERSAILLES KY
40383-1844
US

IV. Provider business mailing address

1221 S BROADWAY
LEXINGTON KY
40504-2701
US

V. Phone/Fax

Practice location:
  • Phone: 859-873-9188
  • Fax: 859-873-0870
Mailing address:
  • Phone: 859-258-6200
  • Fax: 859-258-6203

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number02942
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0102202121
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: