MEDICARE: DR. CARL H. SCHMIDT O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	18001383A	IN

General Provider Information

NPI Number	:	1073728945
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CARL H. SCHMIDT O.D.

Provider Business Mailing Address
First Line	:	1619 E SOUTHPORT RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-5213
Country	:	US
Telephone Number	:	317-783-9497
Fax Number	:

Provider Business Practice Location Address
First Line	:	1619 E SOUTHPORT RD
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46227-5213
Country	:	US
Telephone Number	:	317-783-9497
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/13/2007
Last Update Date	:	06/22/2009

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