Provider Demographics
NPI:1588830723
Name:SCHREINER, BRIAN ALAN (HIS)
Entity Type:Individual
Prefix:MR
First Name:BRIAN
Middle Name:ALAN
Last Name:SCHREINER
Suffix:
Gender:M
Credentials:HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GLASGOW
Mailing Address - State:KY
Mailing Address - Zip Code:42141-2835
Mailing Address - Country:US
Mailing Address - Phone:270-651-8038
Mailing Address - Fax:270-651-8929
Practice Address - Street 1:105 E MAIN ST
Practice Address - Street 2:
Practice Address - City:GLASGOW
Practice Address - State:KY
Practice Address - Zip Code:42141-2835
Practice Address - Country:US
Practice Address - Phone:270-651-8038
Practice Address - Fax:270-651-8929
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-07
Last Update Date:2008-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY252237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000526257OtherANTHEM BLUE CROSS BLUE SHIELD