Healthcare Provider Details

I. General information

NPI: 1992755383
Provider Name (Legal Business Name): GEORGE R SCHOEDINGER III M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/10/2006
Last Update Date: 08/30/2021
Certification Date: 08/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2621 RAYMOND DR
SAINT CHARLES MO
63301-4872
US

IV. Provider business mailing address

2621 RAYMOND DR
SAINT CHARLES MO
63301-4872
US

V. Phone/Fax

Practice location:
  • Phone: 636-946-2244
  • Fax: 636-946-6975
Mailing address:
  • Phone: 636-946-2244
  • Fax: 366-946-6975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberR2700
License Number StateMO
# 2
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberR2700
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: