NPI 1174083018 · live from the CMS NPI Registry
Colin Oliver Bergeron, PA-C
Physician Assistant in Tulsa, OK. National Provider Identifier 1174083018, active.
NPI record
| NPI | 1174083018 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 6161 S Yale Ave, Tulsa, OK 74136 |
| Practice phone | 918-502-3939 |
| Enumerated | March 25, 2019 |
| Last updated | March 25, 2019 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 3014 (OK) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.