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NPI Code Detail

MEDICARE: DR. BRIAN BARCZAK M.D.

MEDICARE: DR. BRIAN BARCZAK M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0804XChild & Adolescent Psychiatry Physician41658KY
22084F0202XForensic Psychiatry Physician255992NY
32084P0800XPsychiatry Physician76418GA

General Provider Information

NPI Number : 1104009398
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. BRIAN BARCZAK M.D.
Provider Business Mailing Address
First Line : 2900 CHAMBLEE TUCKER RD BLDG 16
Second Line :
City : ATLANTA
State : GA
Zip : 30341-4148
Country : US
Telephone Number : 770-939-1288
Fax Number : 770-212-2203
Provider Business Practice Location Address
First Line : 2900 CHAMBLEE TUCKER RD BLDG 16
Second Line :
City : ATLANTA
State : GA
Zip : 30341-4148
Country : US
Telephone Number : 770-939-1288
Fax Number : 770-212-2203
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/11/2007
Last Update Date : 06/25/2024

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