Individual provider · Type 1 NPI

Jack William Bergman, PA-C

Physician Assistant · St. Louis Park, MN

NPI number 1043790553 Active

Practice location

3931 Louisiana Ave S
St. Louis Park, MN 55426-5000

Call (952) 993-3230 Map

Fax (952) 993-1748

Other practice locations

  • 5838 Six Forks Rd Ste 100, Raleigh, NC 27609-3893 · (919) 785-3400

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000X13280 (MN)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1043790553

Jack William Bergman, PA-C's National Provider Identifier is 1043790553, issued on Aug 15, 2018. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in St. Louis Park, MN. The record was last updated on Jan 17, 2020.