Jack L. Berg is a Family Medicine in Shreveport, Louisiana. Jack L. Berg practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Jack L. Berg is 1639160021. The last update date is 2021-06-17.
Jack L. Berg's current location address is 7813 Youree Dr, Shreveport, Louisiana. You can contact this provider via phone number 3182123830 and fax number 3182123835. The mailing address for Jack L. Berg is 7813 Youree Dr, Shreveport, Louisiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jack L. Berg |
|---|---|
| Address | 7813 Youree Dr, Shreveport, Louisiana |
| Phone Number | 3182123830 |
| Fax Number | 3182123835 |
| Sole Proprietor | N |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1639160021 |
|---|---|
| Provider Enumeration Date | 2005-11-03 |
| Last Updated Date | 2021-06-17 |
Provider Mailing Address Detail
| Address | 7813 Youree Dr |
|---|---|
| City | Shreveport |
| State | Louisiana (LA) |
| Post Code | 711055505 |
| Phone Number | 3182123830 |
| Fax Number | 3182123835 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 15000R |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 1160571 | LA | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Jack L. Berg by the Centers for Medicare & Medicaid Services?
The Jack L. Berg has been assigned the NPI (National Provider Identifier) 1639160021 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you provide the complete physical address where Jack L. Berg is located?
The Jack L. Berg is situated at the following address: 7813 Youree Dr, Shreveport, LA, 711055505.
What is Jack L. Berg's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Jack L. Berg's specialized field of practice is Family Medicine, and the corresponding taxonomy code that categorizes this area of specialization is 207Q00000X.
On what date was the 1639160021 assigned to Jack L. Berg?
The Jack L. Berg was issued its 1639160021 on 2005-11-03, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date were the details related to Jack L. Berg most recently updated or revised?
The information pertaining to Jack L. Berg, including its address, specialty, and other relevant details, was last updated or revised on 2021-06-17.
NPI Number: 1215930425
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