- Practice location
- 2200 NE Professional CT, Bend, OR 97701-6063
- Phone
- 541-382-3344
- Fax
- —
- Last updated
- September 11, 2024
Jack Edward Burgeson is a Pediatrics based in Bend, OR. Jack Edward Burgeson practices in Bend, OR and has the professional credentials of MD. The NPI Number for Jack Edward Burgeson is 1194214320 and holds a License No. 35.147258 (OH). The current practice location address for Jack Edward Burgeson is 2200 NE Professional CT, Bend, OR 97701-6063 and can be reached out via phone at 541-382-3344.
Provider Profile Details
- NPI Number
- 1194214320
- Provider Name
- Jack Edward Burgeson
- Credential
- MD
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 2200 NE Professional CT, Bend, OR 97701-6063
- Phone Number
- 541-382-3344
- Primary Taxonomy
- Pediatrics · 208000000X
- Sole Proprietor
- No
- Provider Enumeration Date
- May 3, 2018
- Last Update Date
- September 11, 2024
- Certification Date
- September 11, 2024
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 2200 NE Professional CT
Bend, OR 97701-6063 - City
- Bend
- State
- Oregon
- Zip
- 97701-6063
- Phone Number
- 541-382-3344
Provider Business Mailing Address Details
- Address
- 2200 NE Professional CT
Bend, OR 97701-6063 - City
- Bend
- State
- OR
- Zip
- 97701-6063
- Phone Number
- 541-389-6313
License Information
- License Number (1)
- 35.147258
- License State (1)
- OH
- Taxonomy (1)
- Pediatrics · 208000000X
- License Number (2)
- 11393172-1205
- License State (2)
- UT
- Taxonomy (2)
- Pediatrics · 208000000X
- License Number (3)
- MD217757
- License State (3)
- OR
- Taxonomy (3)
- Pediatrics · 208000000X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Pediatrics providers near Bend, OR
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- Brooks W Booker IV, MDPediatrics · NPI 1376558429
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Frequently Asked Questions
What is the NPI number of Jack E Burgeson, MD?
The NPI number of Jack E Burgeson, MD is 1194214320. It was assigned on May 3, 2018 and is currently active in the NPPES registry.
What is the specialty of Jack E Burgeson, MD?
Jack E Burgeson, MD is registered under the primary taxonomy Pediatrics (code 208000000X), licensed in OH under license number 35.147258.
Where does Jack E Burgeson, MD practice?
The practice location is 2200 NE Professional CT, Bend, OR 97701-6063. The office can be reached at 541-382-3344 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1194214320 directly on the NPPES registry website.