Provider Demographics
NPI:1962498204
Name:BERG, JOSEPH CHANDLER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:CHANDLER
Last Name:BERG
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2709 MEREDYTH DR
Mailing Address - Street 2:SUITE 110
Mailing Address - City:ALBANY
Mailing Address - State:GA
Mailing Address - Zip Code:31707-0222
Mailing Address - Country:US
Mailing Address - Phone:229-432-7012
Mailing Address - Fax:229-435-0211
Practice Address - Street 1:2709 MEREDYTH DR
Practice Address - Street 2:SUITE 110
Practice Address - City:ALBANY
Practice Address - State:GA
Practice Address - Zip Code:31707-0222
Practice Address - Country:US
Practice Address - Phone:229-432-7012
Practice Address - Fax:229-435-0211
Is Sole Proprietor?:No
Enumeration Date:2005-09-22
Last Update Date:2012-01-04
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Provider Licenses
StateLicense IDTaxonomies
GA021643207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00070188BMedicaid
GAD39393Medicare UPIN