Healthcare Provider Details
I. General information
NPI: 1518953991
Provider Name (Legal Business Name): GEORGE F SCHUTZ MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/21/2005
Last Update Date: 02/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3401 W GORE BLVD
LAWTON OK
73505
US
IV. Provider business mailing address
PO BOX 785
LAWTON OK
73502
US
V. Phone/Fax
- Phone: 580-355-8620
- Fax: 580-357-9984
- Phone: 580-357-9984
- Fax: 580-357-3277
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085R0202X |
| Taxonomy | Diagnostic Radiology Physician |
| License Number | 23564 |
| License Number State | OK |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: