Organization
CLEAR CREEK INPATIENT PHYSICIANS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WILLIAM C. JERNBERG (MD)
(214) 712-2403
Entity
Organization
Contact information
Practice address
2201 S CLEAR CREEK RD, KILLEEN, TX 76549-4110
(254) 526-7523
Mailing address
1717 MAIN ST, SUITE 5200, DALLAS, TX 75201-4612
(214) 712-2403
(214) 712-2444
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
N/A
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0052KP
BLUE SHIELD
TX
Enumeration date
08/12/2006
Last updated
12/11/2008
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