Provider Demographics
NPI:1932468246
Name:BERNARD, MARK EDMUND (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:EDMUND
Last Name:BERNARD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:800 ROSE STREET, C114
Mailing Address - Street 2:UK HEALTHCARE DEPARTMENT OF RADIATION MEDICINE
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40536-0293
Mailing Address - Country:US
Mailing Address - Phone:859-257-7168
Mailing Address - Fax:
Practice Address - Street 1:800 ROSE STREE, C114
Practice Address - Street 2:UK HEALTHCARE DEPARTMENT OF RADIATION MEDICINE
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-0293
Practice Address - Country:US
Practice Address - Phone:859-257-7618
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-07
Last Update Date:2017-07-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY502812085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology