1932122108 NPI number — DR. MARK NEAL BERRY CHIROPRACTOR

Table of content: DR. MARK NEAL BERRY CHIROPRACTOR (NPI 1932122108)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1932122108 NPI number — DR. MARK NEAL BERRY CHIROPRACTOR

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
BERRY
Provider First Name:
MARK
Provider Middle Name:
NEAL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
CHIROPRACTOR
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1932122108
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/12/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2515 WATERFORD PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOOVER
Provider Business Mailing Address State Name:
AL
Provider Business Mailing Address Postal Code:
35244-1044
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
205-994-1993
Provider Business Mailing Address Fax Number:
205-639-1441

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1580 MONGOMERY HIGHWAY
Provider Second Line Business Practice Location Address:
14
Provider Business Practice Location Address City Name:
HOOVER
Provider Business Practice Location Address State Name:
AL
Provider Business Practice Location Address Postal Code:
35216-4586
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
205-533-8972
Provider Business Practice Location Address Fax Number:
205-639-1441
Provider Enumeration Date:
07/26/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2158 , registered in the state of AL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com