Individual
BRIAN ANTHONY BALTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 W DREW AVE, MONETTE, AR 72447-9010
(870) 486-5464
(870) 486-1211
Mailing address
210 W DREW AVE, PO BOX 747, MONETTE, AR 72447-9010
(870) 486-5464
(870) 486-1211
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
E7150
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
194152001
—
AR
01
—
5AP26
MEDICARE
—
Enumeration date
06/25/2009
Last updated
01/09/2015
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