=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619705019
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | SENTINEL HEALTH SOLUTIONS LLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/25/2024
-----------------------------------------------------
Last Update Date | 07/25/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4052 E VAN BUREN STE A
-----------------------------------------------------
City | EUREKA SPRINGS
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72632-9328
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-379-8082
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 4052 E VAN BUREN STE A
-----------------------------------------------------
City | EUREKA SPRINGS
-----------------------------------------------------
State | AR
-----------------------------------------------------
Zip | 72632-9328
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 479-379-8082
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PHYSICIAN/ OWNER
-----------------------------------------------------
Name | DR. CHRISTOPHER S BARANYK
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 571-232-6354
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207Q00000X
-----------------------------------------------------
Taxonomy Name | Family Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------