Healthcare Provider Details

I. General information

NPI: 1366080582
Provider Name (Legal Business Name): MATTHEW E. SCHANTZ, M.D.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/18/2019
Last Update Date: 12/18/2019
Certification Date: 12/18/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

206 S MILITARY ST STE 1
LORETTO TN
38469-2101
US

IV. Provider business mailing address

206 S MILITARY ST STE 1
LORETTO TN
38469-2101
US

V. Phone/Fax

Practice location:
  • Phone: 931-853-6136
  • Fax: 931-853-6137
Mailing address:
  • Phone: 931-853-6136
  • Fax: 931-853-6137

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: JOAN P HILL
Title or Position: OFFICE MANAGER
Credential:
Phone: 931-853-6136