Healthcare Provider Details

I. General information

NPI: 1730145285
Provider Name (Legal Business Name): JOHN R. SCHNEIDER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/25/2006
Last Update Date: 05/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2548 RIDEOUT LN
MURFREESBORO TN
37128
US

IV. Provider business mailing address

1173 PIN OAK CIR
BRENTWOOD TN
37027-8903
US

V. Phone/Fax

Practice location:
  • Phone: 615-410-4990
  • Fax: 615-410-4250
Mailing address:
  • Phone: 615-410-4990
  • Fax: 615-410-4250

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number45893
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License Number45893
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number45893
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: