Provider Demographics
NPI:1467525014
Name:BARCHMAN, JEREMY SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:JEREMY
Middle Name:SCOTT
Last Name:BARCHMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21825 FOXHAVEN RUN APT 6
Mailing Address - Street 2:
Mailing Address - City:WAUKESHA
Mailing Address - State:WI
Mailing Address - Zip Code:53186-1835
Mailing Address - Country:US
Mailing Address - Phone:262-798-1593
Mailing Address - Fax:
Practice Address - Street 1:1900 W RYAN RD
Practice Address - Street 2:
Practice Address - City:OAK CREEK
Practice Address - State:WI
Practice Address - Zip Code:53154-8233
Practice Address - Country:US
Practice Address - Phone:414-761-5777
Practice Address - Fax:414-761-7915
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4187-012111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI38966400Medicaid
WI38966400Medicaid