Healthcare Provider Details

I. General information

NPI: 1386005718
Provider Name (Legal Business Name): JEREMY BERGER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/12/2016
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

655 7TH ST
ROBINS AFB GA
31098-2227
US

IV. Provider business mailing address

655 7TH ST
ROBINS AFB GA
31098-2227
US

V. Phone/Fax

Practice location:
  • Phone: 478-327-7850
  • Fax: 888-377-8543
Mailing address:
  • Phone: 478-327-7850
  • Fax: 888-377-8543

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License Number1760
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: