Individual
JEFFREY O BERGSBAKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-7000
(605) 882-7607
Mailing address
401 9TH AVE NW, WATERTOWN, SD 57201-1548
(605) 882-7000
(605) 882-7607
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
4686
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0007246
BCBS
SD
05
—
5700870
—
SD
01
—
59F06BE
BCBS
MN
05
—
901487000
—
MN
Enumeration date
07/28/2006
Last updated
01/20/2020
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