Healthcare Provider Details

I. General information

NPI: 1497804181
Provider Name (Legal Business Name): EARL C. SCHEIDLER ,DO., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2007
Last Update Date: 09/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11043 MAIN ST
CINCINNATI OH
45241-2678
US

IV. Provider business mailing address

11043 MAIN ST
CINCINNATI OH
45241-2678
US

V. Phone/Fax

Practice location:
  • Phone: 513-563-6222
  • Fax: 513-563-2476
Mailing address:
  • Phone: 513-563-1737
  • Fax: 513-563-2476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License NumberAS2790930
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberAS2790930
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAS2790930
License Number StateOH

VIII. Authorized Official

Name: DR. JOSEPH S SCHEIDLER
Title or Position: PRESIDENT
Credential: D.O.
Phone: 513-563-6222