Healthcare Provider Details

I. General information

NPI: 1285949495
Provider Name (Legal Business Name): SCHMITZ FAMILY PRACTICE AND RURAL HEALTH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/11/2010
Last Update Date: 11/23/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1006 E MAIN ST
CHARLESTON AR
72933-9388
US

IV. Provider business mailing address

1006 E MAIN ST
CHARLESTON AR
72933-9388
US

V. Phone/Fax

Practice location:
  • Phone: 479-965-7702
  • Fax: 479-965-2180
Mailing address:
  • Phone: 479-965-7702
  • Fax: 479-965-2180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JAMES L. SCHMITZ
Title or Position: OWNER
Credential: D.O.
Phone: 479-965-7702