MEDICARE: DR. ROBERT TERRY KERBS D.C., C.C.E.P.

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	111NX0800X	Orthopedic Chiropractor	1571	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
4	350051959	OTHER	AR	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	5W153	OTHER	AR	BLUE CROSS & BLUE SHIELD
2	7721141	OTHER	AR	AETNA INSURANCE COMPANY
3	19984000040	OTHER	AR	QUAL CHOICE INSURANCE

General Provider Information

NPI Number	:	1942207964
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT TERRY KERBS D.C., C.C.E.P.

Provider Business Mailing Address
First Line	:	1130 S ROGERS ST
Second Line	:
City	:	CLARKSVILLE
State	:	AR
Zip	:	72830-9157
Country	:	US
Telephone Number	:	479-754-2500
Fax Number	:	479-754-3187

Provider Business Practice Location Address
First Line	:	1130 S ROGERS ST
Second Line	:
City	:	CLARKSVILLE
State	:	AR
Zip	:	72830-9157
Country	:	US
Telephone Number	:	479-754-2500
Fax Number	:	479-754-3187

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

Provider Enumeration Date	:	07/05/2005
Last Update Date	:	02/13/2012

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