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NPI Code Detail

MEDICARE: DR. JEREMY MICHAEL BERNOT M.D.

MEDICARE: DR. JEREMY MICHAEL BERNOT M.D.
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
1208D00000XGeneral Practice Physician28086NE
22085R0202XDiagnostic Radiology Physician28086NE
32085R0202XDiagnostic Radiology PhysicianS8420TX
4390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1972845519
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEREMY MICHAEL BERNOT M.D.
Provider Business Mailing Address
First Line : 1100 WILFORD HALL LOOP BLDG 4554
Second Line :
City : JBSA LACKLAND
State : TX
Zip : 78236-5638
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 9300 DEWITT LOOP
Second Line :
City : FT BELVOIR
State : VA
Zip : 22060-5285
Country : US
Telephone Number : 571-231-3224
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/21/2013
Last Update Date : 01/05/2026

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