Provider Demographics
NPI:1033177084
Name:BERGER, CLAY M (DC)
Entity Type:Individual
Prefix:DR
First Name:CLAY
Middle Name:M
Last Name:BERGER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 W HUDSON RD
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-1958
Mailing Address - Country:US
Mailing Address - Phone:479-636-9495
Mailing Address - Fax:479-636-9449
Practice Address - Street 1:3301 W HUDSON RD
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-1958
Practice Address - Country:US
Practice Address - Phone:479-636-9495
Practice Address - Fax:479-636-9449
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR1595111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5M380OtherCHIROPRACTOR
AR5M380Medicare ID - Type UnspecifiedCHIROPRACTOR
ARV008858Medicare UPIN