Individual
JOHN RANDOL BERGQUIST
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1145 S UTICA AVE STE 701, TULSA, OK 74104-4019
(918) 582-6544
Mailing address
1145 S UTICA AVE STE 110, TULSA, OK 74104-4013
(918) 579-3825
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
38503
OK
208600000X
Surgery Physician
56488
MN
208600000X
Surgery Physician
A160484
CA
2086X0206X
Surgical Oncology Physician
Primary
38503
OK
Other
Enumeration date
06/27/2012
Last updated
02/03/2025
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