Jacob Tyrell Berg, DO is a
Emergency Medicine physician based in Sneads Ferry, North Carolina. Jacob Tyrell Berg is licensed to practice in Florida (license number OS20890) and his current practice location is 205 Smallberry Ct, Sneads Ferry, North Carolina. He can be reached at his office (for appointments etc.) via phone at
(307) 630-9380.
NPI number for Jacob Tyrell Berg is 1538724455 and his current mailing address is 7711 S Sunnycrest Rd, Seattle, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1538724455.
Physician's Profile
| Full Name | Jacob Tyrell Berg |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Location | 205 Smallberry Ct, Sneads Ferry, North Carolina |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1538724455
- Provider Enumeration Date: 05/06/2019
- Last Update Date: 09/30/2024
Medical Identifiers
Medical identifiers for Jacob Tyrell Berg such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1538724455 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207P00000X | Emergency Medicine | OS20890 (Florida) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Jacob Tyrell Berg is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Jacob Tyrell Berg, DO
7711 S Sunnycrest Rd,
Seattle, WA 98178-2749
Ph: (307) 630-9380 | Jacob Tyrell Berg, DO
205 Smallberry Ct,
Sneads Ferry, NC 28460-6827
Ph: (307) 630-9380 |
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