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DR. JOHN SCOTT BARANCHOK PHD

Clinical Neuropsychologist

Rome, Georgia

Provider NPI: 1578542510

Provider Information:
DR. JOHN SCOTT BARANCHOK PHD
Gender: M
Sole Proprietor


Practice Location:
504 RIVERSIDE PKWY NE SUITE 300 ROME, GA 30161 US
Tel: 706-290-0535  Fax: 706-290-1421

Business Mailing Address:
504 RIVERSIDE PKWY NE SUITE 300 ROME, GA 30161 US
Tel: 706-290-0535  Fax: 706-290-1421

Entity Type: Individual

Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y103G00000XBehavioral Health & Social Service Providers
Clinical Neuropsychologist
GA2010
N103TC0700XBehavioral Health & Social Service Providers
Psychologist
GAPSY002010

Other Provider Identifiers:

IssuerNumberStateType
000793174CGA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin







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