Healthcare Provider Details

I. General information

NPI: 1922330372
Provider Name (Legal Business Name): RICHARD CHARLES SCHMIDT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/10/2010
Last Update Date: 02/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6207 HERBIE RD
BILOXI MS
39532-8454
US

IV. Provider business mailing address

6207 HERBIE RD
BILOXI MS
39532-8454
US

V. Phone/Fax

Practice location:
  • Phone: 228-392-6891
  • Fax: 228-392-6891
Mailing address:
  • Phone: 228-392-6891
  • Fax: 228-392-6891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberV-010
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: