Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 143 | AR |
Y | 222Z00000X | Podiatrist | 143 | AR |
NPI | 1003886748 |
---|---|
Provider Name | Bruce Kevin Berkheimer |
First Address | Searcy, AR 72143-4702 |
Second Address | Searcy, AR 72143-4702 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/01/2006 |
Last Update Date | 16/10/2007 |