Berry, Jack T.

Berry, Jack T. is an sole proprietor health care provider with primary practice located at 605 N Foster St , Mitchell SD 57301-2902. He recently has only one registered license in Other Service Providers / Specialist, which is considered as his primary health care specialty. Berry, Jack T. can be contacted via phone (605) 995-5756.

Contact Information

Primary practice address
605 N Foster St Mitchell SD 57301-2902
Phone: (605) 995-5756
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X

Profile Details

NPI number 1235327511
LBN Legal business name Berry, Jack T.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 11th, 2007
Last updated Oct 11th, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1235327511 NPPES
Other 0488 SOUTH DAKOTA LICENSE #

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