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NPI Code Detail

MEDICARE: MRS. CAROL SUE SCHMIDT P.A.

MEDICARE: MRS. CAROL SUE SCHMIDT P.A.
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
1363AM0700XMedical Physician AssistantPA475OK

General Provider Information

NPI Number : 1326030891
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. CAROL SUE SCHMIDT P.A.
Provider Business Mailing Address
First Line : 825 SOUTH KERR BVLD
Second Line :
City : SALLISAW
State : OK
Zip : 74955
Country : US
Telephone Number : 918-776-0263
Fax Number :
Provider Business Practice Location Address
First Line : 301 J T STITES BLVD
Second Line :
City : SALLISAW
State : OK
Zip : 74955-9302
Country : US
Telephone Number : 918-775-9150
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2005
Last Update Date : 07/08/2007

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Directions to “ MRS. CAROL SUE SCHMIDT P.A.” Practice Location

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