Provider Demographics
NPI:1528145588
Name:SCHACH, CHRISTOPHER P (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:P
Last Name:SCHACH
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 1:4375 N. VANTAGE DR.
Mailing Address - Street 2:SUITE 305
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72703-4984
Mailing Address - Country:US
Mailing Address - Phone:479-443-5100
Mailing Address - Fax:479-443-5117
Practice Address - Street 1:4375 N. VANTAGE DR.
Practice Address - Street 2:SUITE 305
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-4984
Practice Address - Country:US
Practice Address - Phone:479-443-5100
Practice Address - Fax:479-443-5117
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE2131207ND0101X, 174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR145679001Medicaid
AR19245000000OtherQUALCHOICE
AR5L348Medicare ID - Type Unspecified
ARH05933Medicare UPIN