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1639160021
JACK L. BERG
SHREVEPORT, LA
NPI
1639160021
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: LA 15000R)
Enumeration Date
2005-11-03
Last Update Date
2021-06-17
Business Address
JACK L. BERG MD
7813 YOUREE DR
SHREVEPORT, LA 71105-5505
Phone number: 318-212-3830
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Mailing Address
JACK L. BERG MD
7813 YOUREE DR
SHREVEPORT, LA 71105-5505
Phone number: 318-212-3830
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