MEDICARE: FRANK DEE BUERGER P.A.

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	363AM0700X	Medical Physician Assistant	PA365	OK
2	363AS0400X	Surgical Physician Assistant	PA365	OK

General Provider Information

NPI Number	:	1356485619
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	FRANK DEE BUERGER P.A.

Provider Business Mailing Address
First Line	:	6613 N MERIDIAN AVE
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73116-1423
Country	:	US
Telephone Number	:	405-951-4110
Fax Number	:	405-951-4111

Provider Business Practice Location Address
First Line	:	5701 N PORTLAND AVE STE 120
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73112-1670
Country	:	US
Telephone Number	:	405-951-4110
Fax Number	:	405-951-4111

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

Provider Enumeration Date	:	02/19/2007
Last Update Date	:	03/01/2017

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