Healthcare Provider Details

I. General information

NPI: 1205817186
Provider Name (Legal Business Name): ERIC MICHAEL SCHACKMUTH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 07/23/2025
Certification Date: 07/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6250 US HIGHWAY 83 ABILENE REGIONAL MEDICAL CENTER RADIOLOGY DEPARTMENT
ABILENE TX
79606-5215
US

IV. Provider business mailing address

5400 N GRAND BLVD STE 260
OKLAHOMA CITY OK
73112-5705
US

V. Phone/Fax

Practice location:
  • Phone: 325-428-1000
  • Fax:
Mailing address:
  • Phone: 405-486-7250
  • Fax: 706-653-1567

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberK1049
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: