Dr. Charles Kenneth Bergdolt, DO
Preventive Medicine, Aerospace Medicine in Pensacola, FL. Individual provider (NPI-1).
NPI number1194392241
StatusActive
Last updated in NPPESJun 25, 2025
Details
- NPI
- 1194392241
- Entity type
- Individual (NPI-1)
- Name
- Dr. Charles Kenneth Bergdolt
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Jun 8, 2021
- Certification date
- Jun 25, 2025
- Last updated
- Jun 25, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2083A0100X | Preventive Medicine, Aerospace Medicine | O-1734 | ID | Yes |
| 207Q00000X | Family Medicine | 8288488 | AL |
Practice location
220 Hovey RdPensacola, FL 32508-1044
Phone 850-542-2933
Mailing address
220 Hovey RdPensacola, FL 32508-1044
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