Healthcare Provider Details

I. General information

NPI: 1942207964
Provider Name (Legal Business Name): ROBERT TERRY KERBS D.C., C.C.E.P.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/05/2005
Last Update Date: 02/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1130 S ROGERS ST
CLARKSVILLE AR
72830-9157
US

IV. Provider business mailing address

1130 S ROGERS ST
CLARKSVILLE AR
72830-9157
US

V. Phone/Fax

Practice location:
  • Phone: 479-754-2500
  • Fax: 479-754-3187
Mailing address:
  • Phone: 479-754-2500
  • Fax: 479-754-3187

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NX0800X
TaxonomyOrthopedic Chiropractor
License Number1571
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: