Provider Demographics
NPI:1265525919
Name:BERNHARDT ANDERSON MEDICAL ASSOCIATES INC
Entity type:Organization
Organization Name:BERNHARDT ANDERSON MEDICAL ASSOCIATES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:GENE
Authorized Official - Last Name:BERNHARDT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-737-6691
Mailing Address - Street 1:2801 PARKLAWN DRIVE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73110-4211
Mailing Address - Country:US
Mailing Address - Phone:405-737-6691
Mailing Address - Fax:405-737-7723
Practice Address - Street 1:2801 PARKLAWN DRIVE
Practice Address - Street 2:SUITE 101
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73110-4211
Practice Address - Country:US
Practice Address - Phone:405-737-6691
Practice Address - Fax:405-737-7723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2011-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK7275261QM2500X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK1174515977OtherNPI # FOR KARIS STEELE,MD
OK1134111933OtherNPI # FOR ROBERT DICKEYMD
OK1659363463OtherNPI # FOR ZEMING DENG MD
OK1356333140OtherNPI # FOR -WM BERNHARDT
OK10073006AMedicaid