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NPI Code Detail

MEDICARE: ERIC MICHAEL SCHACKMUTH M.D.

MEDICARE: ERIC MICHAEL SCHACKMUTH 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
12085R0202XDiagnostic Radiology PhysicianK1049TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1205817186
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC MICHAEL SCHACKMUTH M.D.
Provider Business Mailing Address
First Line : 5400 N GRAND BLVD
Second Line : STE 260
City : OKLAHOMA CITY
State : OK
Zip : 73112-5705
Country : US
Telephone Number : 405-486-7250
Fax Number : 706-653-1567
Provider Business Practice Location Address
First Line : 6250 US HIGHWAY 83
Second Line : ABILENE REGIONAL MEDICAL CENTER RADIOLOGY DEPARTMENT
City : ABILENE
State : TX
Zip : 79606-5215
Country : US
Telephone Number : 325-428-1000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/08/2005
Last Update Date : 07/23/2025

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