Most Relevant Information
Provider Data
| NPI Number: | 1003296153 |
| Provider Name: | ALAN BARTHOLOMEW D.O. |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 06/04/2015 |
| Last Updated: | 08/13/2020 |
Provider Practice Location
301 FISHER ST RM 1F325
KEESLER AFB
MS
395342508
Practice Location Phone/Fax
| Phone: | 8017064520 |
| Fax: |
Provider Mailing Location
88 MDG/SGHJ
4881 SUGAR MAPLE DR.
WRIGHT PATTERSON AFB
OH
45433
Provider Mailing Phone/Fax
| Phone: | 9372576529 |
| Fax: |