MEDICARE: DR. JEROME A SCHWEIKERT DDS

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	1223S0112X	Oral and Maxillofacial Surgery (Dentist)	AZ 1572	AZ

General Provider Information

NPI Number	:	1205894490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEROME A SCHWEIKERT DDS

Provider Business Mailing Address
First Line	:	4025 W BELL RD
Second Line	:	SUITE #9
City	:	PHOENIX
State	:	AZ
Zip	:	85053-2750
Country	:	US
Telephone Number	:	602-978-2890
Fax Number	:

Provider Business Practice Location Address
First Line	:	4025 W BELL RD
Second Line	:	SUITE #9
City	:	PHOENIX
State	:	AZ
Zip	:	85053-2750
Country	:	US
Telephone Number	:	602-978-2890
Fax Number	:

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

Provider Enumeration Date	:	05/04/2006
Last Update Date	:	07/08/2007

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