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General NPI Number Information
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NPI Number | 1306462338
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Entity Type | Organization
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Legal Business Name | SILVER BIRCH LLC
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Dates
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Enumeration Date | 06/25/2020
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Last Update Date | 06/25/2020
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Provider Practice Location Address
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Address Line | 4052 E VAN BUREN STE A
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City | EUREKA SPRINGS
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State | AR
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Zip | 72632-9328
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Country | US
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Telephone | 571-232-6354
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Fax |
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Provider Business Mailing Address
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Address Line | 4052 E VAN BUREN STE A
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City | EUREKA SPRINGS
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State | AR
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Zip | 72632-9328
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Country | US
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Telephone | 571-232-6354
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. CHRISTOPHER STEPHEN BARANYK
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Credential | D.O.
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Telephone | 571-232-6354
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State |
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