Provider Demographics
NPI:1487660981
Name:BERTSCH, BRION ALAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BRION
Middle Name:ALAN
Last Name:BERTSCH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9260 E 1125 S
Mailing Address - Street 2:
Mailing Address - City:FAIRMOUNT
Mailing Address - State:IN
Mailing Address - Zip Code:46928-9585
Mailing Address - Country:US
Mailing Address - Phone:765-998-2708
Mailing Address - Fax:
Practice Address - Street 1:9260 E 1125 S
Practice Address - Street 2:
Practice Address - City:FAIRMOUNT
Practice Address - State:IN
Practice Address - Zip Code:46928-9585
Practice Address - Country:US
Practice Address - Phone:765-998-2708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2007-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031910A2084A0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084A0401XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyAddiction Medicine