Healthcare Provider Details

I. General information

NPI: 1770356370
Provider Name (Legal Business Name): WILLIAM SCHMITZ
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2023
Last Update Date: 03/11/2026
Certification Date: 03/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

815 HIGHLANDER POINT DR
FLOYDS KNOBS IN
47119-9470
US

IV. Provider business mailing address

301 AXIS DR APT 301
LOUISVILLE KY
40206-0128
US

V. Phone/Fax

Practice location:
  • Phone: 812-923-7146
  • Fax:
Mailing address:
  • Phone: 561-531-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA3419
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: