MEDICARE: DR. JENNIFER A SCHROEDER MD

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	207Q00000X	Family Medicine Physician	K6502	TX
2	207Q00000X	Family Medicine Physician	E3089	AR
3	207Q00000X	Family Medicine Physician	E-3089	AR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1134126600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIFER A SCHROEDER MD

Provider Business Mailing Address
First Line	:	2708 RIFE MEDICAL LANE
Second Line	:	SUITE 130
City	:	ROGERS
State	:	AR
Zip	:	72758-1452
Country	:	US
Telephone Number	:	479-338-5555
Fax Number	:	479-338-5533

Provider Business Practice Location Address
First Line	:	2708 RIFE MEDICAL LANE
Second Line	:	SUITE 130
City	:	ROGERS
State	:	AR
Zip	:	72758-1452
Country	:	US
Telephone Number	:	479-338-5555
Fax Number	:	479-338-5533

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

Provider Enumeration Date	:	06/30/2005
Last Update Date	:	09/24/2011

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Directions to “ DR. JENNIFER A SCHROEDER MD” Practice Location

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