Healthcare Provider Details

I. General information

NPI: 1750310371
Provider Name (Legal Business Name): JEFFREY G SCHMAKEL O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 12/30/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3454 OAK ALLEY CT STE 202
TOLEDO OH
43606-1370
US

IV. Provider business mailing address

2237 KINGSTON DR
MAUMEE OH
43537-1122
US

V. Phone/Fax

Practice location:
  • Phone: 419-578-0057
  • Fax: 419-578-0061
Mailing address:
  • Phone: 419-867-1819
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number3372-T967
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number3372-T967
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code152WL0500X
TaxonomyLow Vision Rehabilitation Optometrist
License Number3372-T967
License Number StateOH
# 4
Primary TaxonomyN
Taxonomy Code152WP0200X
TaxonomyPediatric Optometrist
License Number3372-T967
License Number StateOH
# 5
Primary TaxonomyN
Taxonomy Code152WS0006X
TaxonomySports Vision Optometrist
License Number3372-T967
License Number StateOH
# 6
Primary TaxonomyN
Taxonomy Code152WV0400X
TaxonomyVision Therapy Optometrist
License Number3372-T967
License Number StateOH
# 7
Primary TaxonomyN
Taxonomy Code152WX0102X
TaxonomyOccupational Vision Optometrist
License Number3372-T967
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: