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General NPI Number Information
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NPI Number | 1265525919
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Entity Type | Organization
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Legal Business Name | BERNHARDT ANDERSON MEDICAL ASSOCIATES INC
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Dates
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Enumeration Date | 10/02/2006
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Last Update Date | 06/08/2011
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Provider Practice Location Address
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Address Line | 2801 PARKLAWN DRIVE SUITE 101
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City | MIDWEST CITY
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State | OK
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Zip | 73110-4211
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Country | US
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Telephone | 405-737-6691
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Fax | 405-737-7723
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Provider Business Mailing Address
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Address Line | 2801 PARKLAWN DRIVE SUITE 101
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City | MIDWEST CITY
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State | OK
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Zip | 73110-4211
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Country | US
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Telephone | 405-737-6691
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Fax | 405-737-7723
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Authorized Official
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Title or Position | PRESIDENT PHYSICIAN
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Name | DR. WILLIAM GENE BERNHARDT
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Credential | MD
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Telephone | 405-737-6691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 7275
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 7275
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License Number State | OK
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