1750310371 NPI number — DR. JEFFREY G SCHMAKEL O.D.

Table of content: DR. JEFFREY G SCHMAKEL O.D. (NPI 1750310371)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1750310371 NPI number — DR. JEFFREY G SCHMAKEL O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHMAKEL
Provider First Name:
JEFFREY
Provider Middle Name:
G
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
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:
1750310371
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/30/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2237 KINGSTON DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
MAUMEE
Provider Business Mailing Address State Name:
OH
Provider Business Mailing Address Postal Code:
43537-1122
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
419-867-1819
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3454 OAK ALLEY CT
Provider Second Line Business Practice Location Address:
STE 202
Provider Business Practice Location Address City Name:
TOLEDO
Provider Business Practice Location Address State Name:
OH
Provider Business Practice Location Address Postal Code:
43606-1370
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
419-578-0057
Provider Business Practice Location Address Fax Number:
419-578-0061
Provider Enumeration Date:
07/03/2006

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: 152W00000X , with the licence number:  3372-T967 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 152WC0802X , with the licence number: 3372-T967 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WL0500X , with the licence number: 3372-T967 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WP0200X , with the licence number: 3372-T967 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WS0006X , with the licence number: 3372-T967 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WV0400X , with the licence number: 3372-T967 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152WX0102X , with the licence number: 3372-T967 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 341897615 . This is a "TAX ID # OD PRACTICE" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 201624211 . This is a "VIP TAX ID#" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 3372-T967 . This is a "OPTOMETRIC LICENSE#" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 000000141689 . This is a "ANTHEM BC/BS ID#" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 03220 . This is a "PARAMOUNT INSURANCE ID#" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 1119160001 . This is a "DMERC ID#" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".
  • Identifier: 116749 . This is a "EYEMED/ECPA ID #" identifier , issued by the state of ( OH ) . This identifiers is of the category "OTHER".




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