Healthcare Provider Details

I. General information

NPI: 1033169479
Provider Name (Legal Business Name): JOHN P SCHUMACHER PA,CCP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/04/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2300 MANCHESTER EXPY STE 1009
COLUMBUS GA
31904-6877
US

IV. Provider business mailing address

PO BOX 8805
COLUMBUS GA
31908-8805
US

V. Phone/Fax

Practice location:
  • Phone: 706-596-8200
  • Fax: 706-571-0207
Mailing address:
  • Phone: 706-596-8200
  • Fax: 706-571-0207

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number001143
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: