# R DALE BERNAUER MD APMC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Bernauer Clinic
- **Organization subpart:** No

## Provider details

- **NPI number:** 1639333628
- **Authorized official:** LISA E EWING (OFFICE MANAGER)
- **Authorized official phone:** (667) 474-6960

## Contact information

- **Practice address:** 4150 NELSON RD, BLDG D STE 1, LAKE CHARLES, LA 70605
- **Practice address phone:** (337) 474-6960
- **Practice address fax:** (337) 474-6970
- **Mailing address:** 4150 NELSON RD, BLDG D STE 1, LAKE CHARLES, LA 70605
- **Mailing address phone:** (337) 474-6960
- **Mailing address fax:** (337) 474-6970

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | 04478R | LA | Yes |

## Other

- **Enumeration date:** 07/18/2008
- **Last updated:** 03/18/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 1192805 | — | LA |
| 05 | — | 1966789 | — | LA |