Provider Demographics
NPI:1053502377
Name:BARCZAK, SYLVESTER (MD)
Entity Type:Individual
Prefix:
First Name:SYLVESTER
Middle Name:
Last Name:BARCZAK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 GEORGETOWN DR
Mailing Address - Street 2:
Mailing Address - City:FT MITCHELL
Mailing Address - State:KY
Mailing Address - Zip Code:41017-2858
Mailing Address - Country:US
Mailing Address - Phone:859-331-6242
Mailing Address - Fax:
Practice Address - Street 1:6 GEORGETOWN DR
Practice Address - Street 2:
Practice Address - City:FT MITCHELL
Practice Address - State:KY
Practice Address - Zip Code:41017-2858
Practice Address - Country:US
Practice Address - Phone:859-331-6242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-05
Last Update Date:2007-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY20740207P00000X
OH35-040717207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine