Individual
DR. JOHN SCOTT BARANCHOK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
504 RIVERSIDE PKWY NE, SUITE 300, ROME, GA 30161-2982
(706) 290-0535
(706) 290-1421
Mailing address
504 RIVERSIDE PKWY NE, SUITE 300, ROME, GA 30161-2982
(706) 290-0535
(706) 290-1421
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
2010
GA
103TC0700X
Clinical Psychologist
PSY002010
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000793174C
—
GA
Enumeration date
01/10/2006
Last updated
06/24/2014
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