NPI 1174107866

Bert Edmond Ketchum, OD

Practitioner Optometrist Fpo, AA

Practice location

Address: Usnh/Usnmrtc Guantanamo Bay, Cuba Psc 1005 Box 110185, Fpo, AA 34009
Phone: (757) 458-2998

Registered specialties

Optometrist Primary

Eye and Vision Services Providers Taxonomy 152W00000X Licence 0618003037 (VA)

Other Optometrist providers in Armed Forces Americas →

Registry record

NPI: 1174107866
Entity type: Individual
Sex (as registered): Male
NPI issued: 8 May 2021
Record last updated: 6 Jun 2024

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.