Healthcare Provider Details

I. General information

NPI: 1669572970
Provider Name (Legal Business Name): MICHAEL S SCHMIDT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/25/2006
Last Update Date: 08/07/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

454 SMITH AVE
THOMASVILLE GA
31792-5535
US

IV. Provider business mailing address

454 SMITH AVE
THOMASVILLE GA
31792-0040
US

V. Phone/Fax

Practice location:
  • Phone: 229-227-5510
  • Fax: 229-227-5527
Mailing address:
  • Phone: 229-584-2540
  • Fax: 229-226-2036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number058500
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: