Healthcare Provider Details

I. General information

NPI: 1538251046
Provider Name (Legal Business Name): JOSEPH GERARD SCHAAF M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 01/10/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 N 30TH ST
LARAMIE WY
82072-5140
US

IV. Provider business mailing address

255 N 30TH ST
LARAMIE WY
82072-5140
US

V. Phone/Fax

Practice location:
  • Phone: 307-742-2142
  • Fax: 307-755-4307
Mailing address:
  • Phone: 307-742-2142
  • Fax: 307-755-4307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number7864A
License Number StateWY
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5079
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: