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Individual

JACK EDWARD BURGESON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
2200 NE PROFESSIONAL CT, BEND, OR 97701-6063
(541) 382-3344
Mailing address
2200 NE PROFESSIONAL CT, BEND, OR 97701-6063
(541) 389-6313

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
11393172-1205
UT
208000000X
Pediatrics Physician
35.147258
OH
208000000X
Pediatrics Physician
Primary
MD217757
OR

Other

Enumeration date
05/03/2018
Last updated
09/11/2024
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