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1144214594

NPI Code Detail

MEDICARE: MS. JENNIFER LEIGH SCHUTTER M.D.

MEDICARE: MS. JENNIFER LEIGH SCHUTTER M.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	207R00000X	Internal Medicine Physician	2002008094	MO
2	207R00000X	Internal Medicine Physician	04-29770	KS
3	207R00000X	Internal Medicine Physician	R0950	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	502470	OTHER		FIRST GUARD
3	7474346	OTHER		AETNA
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	31206011	OTHER		BCBS

General Provider Information

NPI Number	:	1144214594
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JENNIFER LEIGH SCHUTTER M.D.

Provider Business Mailing Address
First Line	:	6451 BRENTWOOD STAIR RD
Second Line	:	SUITE 100
City	:	FORT WORTH
State	:	TX
Zip	:	76112-3200
Country	:	US
Telephone Number	:	972-249-0200
Fax Number	:	972-249-0206

Provider Business Practice Location Address
First Line	:	1301 PENNSYLVANIA AVE
Second Line	:
City	:	FORT WORTH
State	:	TX
Zip	:	76104-2122
Country	:	US
Telephone Number	:	972-249-0200
Fax Number	:

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

Provider Enumeration Date	:	08/31/2005
Last Update Date	:	03/02/2017

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Directions to “ MS. JENNIFER LEIGH SCHUTTER M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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