Healthcare Provider Details

I. General information

NPI: 1558332411
Provider Name (Legal Business Name): BRADLEY A SCHMIDT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2006
Last Update Date: 11/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1850 STATE ST
NEW ALBANY IN
47150-4990
US

IV. Provider business mailing address

PO BOX 70101
LOUISVILLE KY
40270-0101
US

V. Phone/Fax

Practice location:
  • Phone: 812-944-7701
  • Fax:
Mailing address:
  • Phone: 812-945-3916
  • Fax: 812-944-3404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01058990A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: