Healthcare Provider Details

I. General information

NPI: 1740850817
Provider Name (Legal Business Name): ZACHARY AARON BRITSTONE-SCHWARTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2021
Last Update Date: 09/30/2024
Certification Date: 09/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

313 FEDERAL DR NW STE 200
CORYDON IN
47112-3079
US

IV. Provider business mailing address

313 FEDERAL DR NW STE 200
CORYDON IN
47112-3079
US

V. Phone/Fax

Practice location:
  • Phone: 812-738-4155
  • Fax: 812-738-6104
Mailing address:
  • Phone: 812-738-4155
  • Fax: 812-738-6104

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01092119A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: