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:
Health care specialties
| Specialty | Code | License # | 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 4 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 | 1467408682 | NPPES |
| Oregon | MEDICAID | 022708 |
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