Individual
RICHARD A OBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
708 W FOREST AVE, JACKSON, TN 38301-3901
(731) 660-8759
Mailing address
1804 HIGHWAY 45 BYP, SUITE 604, JACKSON, TN 38305-4436
(731) 660-8759
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
13728
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
220016968
RR MEDICARE
—
05
—
3050991
—
TN
05
—
3050999
—
TN
01
—
3067964
BCBS
—
Enumeration date
03/02/2006
Last updated
07/17/2009
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