MEDICARE: JEFFREY R SCHMIDT 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	213E00000X	Podiatrist	147	SD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
5	480020837	OTHER	SD	RAILROAD MEDICARE

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
3	22403	OTHER	SD	SIOUX VALLEY HEALTH PLANS
4	1642	OTHER	SD	AVERA HEALTH PLANS

General Provider Information

NPI Number	:	1598769457
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY R SCHMIDT D.P.M.

Provider Business Mailing Address
First Line	:	PO BOX 932
Second Line	:
City	:	MITCHELL
State	:	SD
Zip	:	57301-0932
Country	:	US
Telephone Number	:	605-996-8171
Fax Number	:	605-996-8171

Provider Business Practice Location Address
First Line	:	501 S OHLMAN ST
Second Line	:
City	:	MITCHELL
State	:	SD
Zip	:	57301-3108
Country	:	US
Telephone Number	:	605-996-8171
Fax Number	:	605-996-8171

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

Provider Enumeration Date	:	06/09/2005
Last Update Date	:	07/23/2008

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Directions to “ JEFFREY R SCHMIDT D.P.M.” Practice Location

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