Dr. Stephen Russell Bergman
Sports Medicine Doctor General Practice Physician Neuromusculoskeletal Medicine (NMM)
800 W Jefferson St
Kirksville
, Missouri 63501-1443
Dr. Stephen Russell Bergman
Sports Medicine Doctor General Practice Physician Neuromusculoskeletal Medicine (NMM)
800 W Jefferson St
Kirksville
, Missouri 63501-1443
(660) 626-2626
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About
Features
Specialties
- Sports Medicine Doctor
- Neuromusculoskeletal Medicine (NMM)
- General Practice Physician
Languages spoken
- English
Location
First Address
- Dr. Stephen Russell Bergman
- 800 W Jefferson St
- Kirksville, MO
- Zip : 63501-1443
- Fax : (660) 626-2626
- Phone : (660) 626-2304
Second Address
- Dr. Stephen Russell Bergman
- 800 W Jefferson St
- Kirksville, MO
- Zip : 63501-1443
- Fax : (660) 626-2626
- Phone : (660) 626-2304
Reviews
FAQs
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 204C00000X | Sports Medicine Doctor | E-12201 | AR |
| N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 2007018743 | MO |
| N | 208D00000X | General Practice Physician | 2007018743 | MO |
| N | 208D00000X | General Practice Physician | E-12201 | AR |
National Provider Identifier
| NPI | 1609021104 |
|---|---|
| Provider Name | Dr. Stephen Russell Bergman |
| First Address | Kirksville, MO 63501-1443 |
| Second Address | Kirksville, MO 63501-1443 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 25/11/2008 |
| Last Update Date | 03/07/2019 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 108400081 | PTAN (01) | MO |
| 1609021104 | (05) | MO |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.