1619915410 NPI number — W JOSEPH SCHOEPPNER DPM

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1619915410 NPI number — W JOSEPH SCHOEPPNER DPM

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

SCHOEPPNER

Provider First Name:

W JOSEPH

Provider Middle Name:

Provider Name Prefix Text:

Provider Name Suffix Text:

Provider Credential Text:

DPM

Provider Gender Code:

M

Provider Other Organization Name:

Provider Other Organization Name Type Code:

Provider Other Last Name:

Provider Other First Name:

Provider Other Middle Name:

Provider Other Name Prefix Text:

Provider Other Name Suffix Text:

Provider Other Credential Text:

Provider Other Last Name Type Code:

NPI Number:

1619915410

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/29/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

3333 MASSILLON RD STE 203

Provider Second Line Business Mailing Address:

Provider Business Mailing Address City Name:

AKRON

Provider Business Mailing Address State Name:

OH

Provider Business Mailing Address Postal Code:

44312-5992

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

330-899-9160

Provider Business Mailing Address Fax Number:

330-899-9170

Provider First Line Business Practice Location Address:

3333 MASSILLON RD

Provider Second Line Business Practice Location Address:

SUITE 203

Provider Business Practice Location Address City Name:

AKRON

Provider Business Practice Location Address State Name:

OH

Provider Business Practice Location Address Postal Code:

44312-5981

Provider Business Practice Location Address Country Code:

US

Provider Business Practice Location Address Telephone Number:

330-899-9160

Provider Business Practice Location Address Fax Number:

330-899-9170

Provider Enumeration Date:

06/03/2006

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 213ES0103X , with the licence number:  36-00-2970-S , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 000000209328 . This is a "UNISON" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 282724719011 . This is a "MEDICAL MUTUAL OF OHIO" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 4701755 . This is a "CIGNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 2009730 , issued by the state of ( OH ) . This identifiers is of the category "MEDICAID".
• Identifier: 341866609027 . This is a "CARESOURSE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 5129533 . This is a "AETNA" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 000000361297 . This is a "ANTHEM" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 34186660900 . This is a "BWC" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 729292 . This is a "BCHP" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: Q005062 . This is a "HOMETOWN HEALTH PLAN" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: 2700953 . This is a "EVERCARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
• Identifier: P00709858 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".