Bergman, Stephen Russell

Bergman, Stephen Russell is an sole proprietor health care provider with primary practice located at 6965 Cumberland Gap Pkwy , Harrogate TN 37752-8245. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM, Allopathic & Osteopathic Physicians / General Practice, Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine, Sports Medicine. Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine, Sports Medicine is his primary health care specialty. Bergman, Stephen Russell can be contacted via phone (423) 869-6249.

Contact Information

Primary practice address
6965 Cumberland Gap Pkwy Harrogate TN 37752-8245
Phone: (423) 869-6249
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine & OMM 204D00000X 2007018743 Missouri
Allopathic & Osteopathic Physicians / General Practice 208D00000X E-12201 Arkansas
Allopathic & Osteopathic Physicians / General Practice 208D00000X 2007018743 Missouri
Allopathic & Osteopathic Physicians / Neuromusculoskeletal Medicine, Sports Medicine 204C00000X E-12201 Arkansas

Profile Details

NPI number 1609021104
LBN Legal business name Bergman, Stephen Russell
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 25th, 2008
Last updated Mar 20th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609021104 NPPES
Missouri Other 108400081 PTAN
Missouri MEDICAID 1609021104 PTAN

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