Healthcare Provider Details

I. General information

NPI: 1912068099
Provider Name (Legal Business Name): MICHAEL PAUL SCHEIDLER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 12/12/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

109 E MAIN ST
CRAWFORDSVILLE IN
47933-1710
US

IV. Provider business mailing address

109 EAST MAIN STREET
CRAWFORDSVILLE IN
47933
US

V. Phone/Fax

Practice location:
  • Phone: 765-362-2706
  • Fax: 765-362-2985
Mailing address:
  • Phone: 765-362-2706
  • Fax: 765-362-2985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number18002838A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number18002838A
License Number StateIN
# 3
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number18002838A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number18002838A
License Number StateIN
# 5
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number18002838A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: