Active NPI
Mark Christian Liedberg, D.C.
- Chiropractor
- Trenton, GA
National Provider Identifier
1265647374
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- CHIRO002739
- Practice address
- 4467 Highway 136 West
Trenton, GA 30752-0799 - Phone
- (706) 657-7581
- Fax
- (706) 657-2080
- NPI assigned
- May 11, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor | 111N00000X | CHIRO002739 | GA | Primary |
Addresses
Primary practice location
4467 Highway 136 West
Trenton, GA 30752-0799
Mailing address
PO Box 799
Highway 136 West
Trenton, GA 30752-0799
Phone (706) 657-7581
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2739 | GA | MD | Counseling Psychologist |
| CHIRO002739 | GA | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1265647374",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 799",
"address_2": "HIGHWAY 136 WEST",
"city": "TRENTON",
"state": "GA",
"postal_code": "307520799",
"telephone_number": "706-657-7581",
"fax_number": "706-657-2080"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4467 HIGHWAY 136 WEST",
"city": "TRENTON",
"state": "GA",
"postal_code": "307520799",
"telephone_number": "706-657-7581",
"fax_number": "706-657-2080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEDBERG",
"first_name": "MARK",
"middle_name": "CHRISTIAN",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "GA",
"license": "CHIRO002739",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trenton, GA
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- Stephanie Wolfrum Lawson, FNP-C
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- Lookout Mountain Community Services
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- Lookout Mountain Community Services
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.