MEDICARE: BARRY BERCH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2086S0120X	Pediatric Surgery Physician	32773	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124175013
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BARRY BERCH MD

Provider Business Mailing Address
First Line	:	6600 S YALE AVE STE 1200
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-3361
Country	:	US
Telephone Number	:	918-499-4854
Fax Number	:	918-488-6098

Provider Business Practice Location Address
First Line	:	6151 S YALE AVE STE 1305
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74136-1907
Country	:	US
Telephone Number	:	918-494-9450
Fax Number	:	918-494-9437

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/04/2007
Last Update Date	:	04/09/2026

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Directions to “ BARRY BERCH MD” Practice Location

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