1275508368 NPI number — DR. HUGH A SCHUETZ D.O.

Table of content: DR. HUGH A SCHUETZ D.O. (NPI 1275508368)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275508368 NPI number — DR. HUGH A SCHUETZ D.O.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHUETZ
Provider First Name:
HUGH
Provider Middle Name:
A
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
D.O.
Provider Gender Code:
M

Provider's Other Name Information

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 Information

NPI Number:
1275508368
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/07/2010
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1000 N JEFFERSON ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SAINT JAMES
Provider Business Mailing Address State Name:
MO
Provider Business Mailing Address Postal Code:
65559-1078
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
573-265-8840
Provider Business Mailing Address Fax Number:
573-265-8884

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1000 N JEFFERSON ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SAINT JAMES
Provider Business Practice Location Address State Name:
MO
Provider Business Practice Location Address Postal Code:
65559-1078
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
573-265-8840
Provider Business Practice Location Address Fax Number:
573-265-8884
Provider Enumeration Date:
02/22/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  111580 , registered in the state of MO ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 248881609 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 296573 . This is a "HEALTHLINK" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 596841403 , issued by the state of ( MO ) . This identifiers is of the category "MEDICAID".
  • Identifier: 431908560 . This is a "PHCS" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 5512537 . This is a "AETNA" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 431908560 . This is a "TRIWEST" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 0100828 . This is a "UNITED HEALTH CARE" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".
  • Identifier: 117532 . This is a "GROUP HEALTH PLAN" identifier , issued by the state of ( MO ) . This identifiers is of the category "OTHER".




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