| Tony L Berg, MD | |
|
809 Jackson St, Burke, SD 57523-2065 | |
| (605) 775-2631 | |
| (605) 775-2564 |
| Full Name | Tony L Berg |
|---|---|
| Gender | Male |
| Speciality | Family Medicine |
| Location | 809 Jackson St, Burke, South Dakota |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053492827 | NPI | - | NPPES |
| 560052 | Medicaid | SD | |
| 0851370001 | Other | DME | |
| 5600050 | Medicaid | SD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 2460 (South Dakota) | Primary |
| Entity Name | Winner Regional Healthcare Center |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1538233549 PECOS PAC ID: 5597663963 Enrollment ID: O20031222000890 |
| Entity Name | Community Memorial Hospital Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1447293196 PECOS PAC ID: 2163317900 Enrollment ID: O20040219000507 |
| Entity Name | Horizon Health Care Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356459382 PECOS PAC ID: 8921997933 Enrollment ID: O20040315000974 |
| Mailing Address | Practice Location Address |
|---|---|
| Tony L Berg, MD Po Box 319, Burke, SD 57523-0319 Ph: (605) 775-2631 | Tony L Berg, MD 809 Jackson St, Burke, SD 57523-2065 Ph: (605) 775-2631 |
Mary S Carpenter, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 809 Jackson St, Burke, SD 57523 Phone: 605-775-2631 Fax: 605-775-2564 | |
Megan M Smith, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 809 Jackson St, Burke, SD 57523 Phone: 605-775-2631 |