Individual
JACK E BERNDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1715 SW CHANDLER AVE, BEND, OR 97702-3615
(541) 588-5620
(888) 625-0286
Mailing address
1715 SW CHANDLER AVE, BEND, OR 97702-3615
(541) 588-5620
(888) 625-0286
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD25340
OR
208VP0000X
Pain Medicine Physician
Primary
MD25340
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
022708
—
OR
Enumeration date
05/26/2006
Last updated
05/18/2022
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