1699779314 NPI number — DR. JULIO F SCHWARZ MD

Table of content: DR. JULIO F SCHWARZ MD (NPI 1699779314)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699779314 NPI number — DR. JULIO F SCHWARZ MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHWARZ
Provider First Name:
JULIO
Provider Middle Name:
F
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1699779314
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6101 PHOENIX AVE
Provider Second Line Business Mailing Address:
CON / ARC PLACE # 3
Provider Business Mailing Address City Name:
FORT SMITH
Provider Business Mailing Address State Name:
AR
Provider Business Mailing Address Postal Code:
72903-5083
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
479-573-3042
Provider Business Mailing Address Fax Number:
479-452-2924

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6101 PHOENIX AVE
Provider Second Line Business Practice Location Address:
CON/ARC PLACE #3
Provider Business Practice Location Address City Name:
FORT SMITH
Provider Business Practice Location Address State Name:
AR
Provider Business Practice Location Address Postal Code:
72903-5083
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
479-709-7300
Provider Business Practice Location Address Fax Number:
479-709-7308
Provider Enumeration Date:
06/09/2005

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207RC0000X , with the licence number:  R3827 , registered in the state of AR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 114852001 , issued by the state of ( AR ) . This identifiers is of the category "MEDICAID".
  • Identifier: 51100 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 060064086 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( AR ) . This identifiers is of the category "OTHER".
  • Identifier: 100260020A , issued by the state of ( OK ) . This identifiers is of the category "MEDICAID".