MEDICARE: DR. ROBERT A GOLDBERG DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	DC007714L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1601699	OTHER	PA	BCBS
2	300293906	OTHER	PA	COMMERCIAL
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	432048389	OTHER	PA	COMMERCIAL

General Provider Information

NPI Number	:	1316930498
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT A GOLDBERG DC

Provider Business Mailing Address
First Line	:	1650 COCHRANE CIRCLE DEPT OF SURGERY/CHIROPRACTIC
Second Line	:	FORT CARSON ARMY BASE
City	:	FT CARSON
State	:	CO
Zip	:	80913
Country	:	US
Telephone Number	:	724-387-2455
Fax Number	:	724-387-2456

Provider Business Practice Location Address
First Line	:	1650 COCHRANE CIR UNIT MEDDAC
Second Line	:
City	:	FT CARSON
State	:	CO
Zip	:	80913-4604
Country	:	US
Telephone Number	:	719-526-7120
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/24/2005
Last Update Date	:	01/07/2025

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