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General NPI Number Information
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NPI Number | 1316526148
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Entity Type | Individual
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Provider Name | ERICH J BERG DO
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Gender | Male
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Dates
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Enumeration Date | 04/07/2021
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Last Update Date | 04/23/2025
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Provider Practice Location Address
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Address Line | 302 W 14TH ST STE 100A
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City | JEFFERSONVILLE
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State | IN
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Zip | 47130-3751
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Country | US
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Telephone | 812-284-0660
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Fax | 812-284-3822
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Provider Business Mailing Address
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Address Line | 550 SOUTH JACKSON STREET ACB, 3RD FLOOR
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City | LOUISVILLE
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State | KY
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Zip | 40202
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Country | US
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Telephone | 502-852-5666
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Fax | 502-852-8980
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 02008197A
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License Number State | IN
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