Healthcare Provider Details

I. General information

NPI: 1922007368
Provider Name (Legal Business Name): ERIC E SCHMIDT O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

409 E BROAD ST
ELIZABETHTOWN NC
28337-8807
US

IV. Provider business mailing address

409 E BROAD ST PO BOX 2589
ELIZABETHTOWN NC
28337-8807
US

V. Phone/Fax

Practice location:
  • Phone: 910-862-4268
  • Fax:
Mailing address:
  • Phone: 910-862-4268
  • Fax: 910-862-2057

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number1446
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: