Berndt, Jack E

Berndt, Jack E is an individual health care provider with primary practice located at 1715 Sw Chandler Ave , Bend OR 97702-3615. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Pain Medicine is his primary health care specialty. Berndt, Jack E can be contacted via phone (541) 588-5620.

Contact Information

Primary practice address
1715 Sw Chandler Ave Bend OR 97702-3615
Phone: (541) 588-5620
Fax: (888) 625-0286
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X MD25340 Oregon
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X MD25340 Oregon

Profile Details

NPI number 1467408682
LBN Legal business name Berndt, Jack E
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 26th, 2006
Last updated May 18th, 2022 - 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 1467408682 NPPES
Oregon MEDICAID 022708

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