Bedke, Brent J
Bedke, Brent J is an individual health care provider with primary practice located at 1740 Sycamore Ave Ste C , Kingman AZ 86409-1039. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine, Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology. Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology is his primary health care specialty. Bedke, Brent J can be contacted via phone (507) 284-2511.Contact Information
Primary practice address
1740 Sycamore Ave Ste C
Kingman AZ 86409-1039
Phone: (507) 284-2511
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Clinical Pathology/Laboratory Medicine | 207ZP0105X | 52935 | Minnesota |
| Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology | 207ZP0102X | 48849 | Arizona |
Profile Details
| NPI number | 1417186305 |
|---|---|
| LBN Legal business name | Bedke, Brent J |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 13th, 2009 |
| Last updated | Mar 17th, 2018 - about 6 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1417186305 | NPPES |
| Arizona | MEDICAID | 916106 |
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