MEDICARE: MATTHEW E. SCHANTZ, M.D.

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	261QP2300X	Primary Care Clinic/Center

General Provider Information

NPI Number	:	1366080582
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MATTHEW E. SCHANTZ, M.D.

Provider Business Mailing Address
First Line	:	206 S MILITARY ST STE 1
Second Line	:
City	:	LORETTO
State	:	TN
Zip	:	38469-2101
Country	:	US
Telephone Number	:	931-853-6136
Fax Number	:	931-853-6137

Provider Business Practice Location Address
First Line	:	206 S MILITARY ST STE 1
Second Line	:
City	:	LORETTO
State	:	TN
Zip	:	38469-2101
Country	:	US
Telephone Number	:	931-853-6136
Fax Number	:	931-853-6137

Authorized Official
Title or Position	:	OFFICE MANAGER
Name	:	JOAN P HILL
Credential	:
Telephone Number	:	931-853-6136

Provider Enumeration Date	:	12/18/2019
Last Update Date	:	12/18/2019

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