Individual
BRIAN W SCHACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
79 COUNTRY CLUB DRIVE, BUTLER, KY 41006
(859) 654-2283
(859) 654-2284
Mailing address
PO BOX 635283, CINCINNATI, OH 45263-5283
(859) 654-2283
(859) 654-2284
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35629
KY
208000000X
Pediatrics Physician
35629
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110208628
RAILROAD MEDICARE
KY
05
—
2269736
—
OH
05
—
64014483
—
KY
01
—
P00839846
RAILROAD MEDICARE
KY
Enumeration date
06/22/2006
Last updated
09/11/2018
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