Healthcare Provider Details

I. General information

NPI: 1033291778
Provider Name (Legal Business Name): ROBERT EUGENE SCHMIEG JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/20/2006
Last Update Date: 12/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 N STATE ST
JACKSON MS
39216-4500
US

IV. Provider business mailing address

PO BOX 24146
JACKSON MS
39207-3287
US

V. Phone/Fax

Practice location:
  • Phone: 601-984-1000
  • Fax: 601-926-4978
Mailing address:
  • Phone: 601-984-1000
  • Fax: 601-926-4978

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number17584
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: