Healthcare Provider Details

I. General information

NPI: 1922062967
Provider Name (Legal Business Name): THOMAS JOSEPH SCHREINER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5880 CHUCKEY PIKE
CHUCKEY TN
37641-6252
US

IV. Provider business mailing address

5880 CHUCKEY PIKE
CHUCKEY TN
37641-6252
US

V. Phone/Fax

Practice location:
  • Phone: 218-841-4573
  • Fax:
Mailing address:
  • Phone: 218-414-5738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number25021
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number65259
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: