Provider Demographics
NPI:1245593581
Name:BEDNARCZYK, STEVEN JOSEPH (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JOSEPH
Last Name:BEDNARCZYK
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 173
Mailing Address - Street 2:
Mailing Address - City:EDMOND
Mailing Address - State:OK
Mailing Address - Zip Code:73083-0173
Mailing Address - Country:US
Mailing Address - Phone:405-861-1522
Mailing Address - Fax:
Practice Address - Street 1:10710 GATEWAY BLVD N STE B2
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79924-1741
Practice Address - Country:US
Practice Address - Phone:915-201-6729
Practice Address - Fax:800-887-2301
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXQ3481207P00000X, 207Q00000X, 2083A0100X, 208D00000X
OK6880207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No2083A0100XAllopathic & Osteopathic PhysiciansPreventive MedicineAerospace Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice