Provider Demographics
NPI:1023005238
Name:BERNARD, JOHN R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:BERNARD
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Gender:M
Credentials:MD
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Mailing Address - Street 1:12330 METCALF AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66213-1324
Mailing Address - Country:US
Mailing Address - Phone:913-317-7990
Mailing Address - Fax:913-317-7018
Practice Address - Street 1:12330 METCALF AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66213-1324
Practice Address - Country:US
Practice Address - Phone:913-317-7990
Practice Address - Fax:913-317-7018
Is Sole Proprietor?:No
Enumeration Date:2005-10-03
Last Update Date:2013-02-15
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Provider Licenses
StateLicense IDTaxonomies
KS0425085207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KSG93000015Medicare PIN
F82133Medicare UPIN