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General NPI Number Information
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NPI Number | 1508941139
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Entity Type | Individual
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Provider Name | ROBERT JAMES BERT MD
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Gender | Male
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Dates
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Enumeration Date | 10/25/2006
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Last Update Date | 11/13/2013
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Provider Practice Location Address
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Address Line | 530 S JACKSON ST SUITE C07
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City | LOUISVILLE
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State | KY
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Zip | 40202-1675
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Country | US
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Telephone | 502-852-5875
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Fax | 502-852-1754
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Provider Business Mailing Address
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Address Line | PO BOX 909
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City | LOUISVILLE
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State | KY
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Zip | 40201-0909
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Country | US
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Telephone | 502-588-0320
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Fax | 502-588-0326
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085N0700X
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Taxonomy Name | Neuroradiology Physician
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License Number | DR.0032145
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | DR.0032145
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 2085D0003X
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Taxonomy Name | Diagnostic Neuroimaging (Radiology) Physician
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License Number | DR.0032145
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License Number State | CO
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