MEDICARE: DR. KENNETH WILFORD SCHMUTZ D.P.M.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0131X	Foot Surgery Podiatrist	0040	NV

General Provider Information

NPI Number	:	1043270317
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KENNETH WILFORD SCHMUTZ D.P.M.

Provider Business Mailing Address
First Line	:	3777 S PECOS MCLEOD
Second Line	:	SUITE 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4265
Country	:	US
Telephone Number	:	702-434-2023
Fax Number	:	702-434-1976

Provider Business Practice Location Address
First Line	:	3777 S PECOS MCLEOD
Second Line	:	SUITE 103
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-4265
Country	:	US
Telephone Number	:	702-434-2023
Fax Number	:	702-434-1976

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2006
Last Update Date	:	04/10/2008

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