1467503623 NPI number — BARBARA J. SCHREIBER-EARL P.A.-C

Table of content: BARBARA J. SCHREIBER-EARL P.A.-C (NPI 1467503623)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467503623 NPI number — BARBARA J. SCHREIBER-EARL P.A.-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHREIBER-EARL
Provider First Name:
BARBARA
Provider Middle Name:
J.
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
P.A.-C
Provider Gender Code:
F

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:
1467503623
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/22/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2202 N FORBES BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85745-1412
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-498-6467
Provider Business Mailing Address Fax Number:
520-531-1424

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
551 W MAGEE RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TUCSON
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85704-6439
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
520-498-6467
Provider Business Practice Location Address Fax Number:
520-531-1424
Provider Enumeration Date:
01/15/2007

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: 363AM0700X , with the licence number:  1101 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 283214 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".
  • Identifier: 118929 . This is a "MEDICARE PTAN" identifier . This identifiers is of the category "OTHER".




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