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General NPI Number Information
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NPI Number | 1972587061
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Entity Type | Individual
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Provider Name | BERNARD E. RERRI MD
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Gender | Male
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Dates
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Enumeration Date | 12/01/2005
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Last Update Date | 10/10/2022
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Provider Practice Location Address
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Address Line | 938 ML KING DR.
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City | CENTRAILIA
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State | IL
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Zip | 62801
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Country | US
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Telephone | 618-918-2262
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Fax | 618-918-3623
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Provider Business Mailing Address
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Address Line | 938 M L KING DR
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City | CENTRALIA
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State | IL
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Zip | 62801-3058
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Country | US
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Telephone | 618-918-2262
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Fax | 618-918-3623
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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 | 207XS0117X
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Taxonomy Name | Orthopaedic Surgery of the Spine Physician
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License Number | 036128561
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License Number State | IL
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Taxonomy #2
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 036128561
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License Number State | IL
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