Provider Demographics
NPI:1063539625
Name:BERRY, DONALD STUART (DO, DC)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:STUART
Last Name:BERRY
Suffix:
Gender:M
Credentials:DO, DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3130 WINDSOR LN
Mailing Address - Street 2:
Mailing Address - City:JANESVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:53546-1906
Mailing Address - Country:US
Mailing Address - Phone:608-746-3585
Mailing Address - Fax:
Practice Address - Street 1:3130 WINDSOR LN
Practice Address - Street 2:
Practice Address - City:JANESVILLE
Practice Address - State:WI
Practice Address - Zip Code:53546-1906
Practice Address - Country:US
Practice Address - Phone:608-746-3585
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2024-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI77025-21207ZC0006X, 2083P0901X, 208D00000X, 251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical Pathology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No251K00000XAgenciesPublic Health or Welfare