MEDICARE: ERIC ALAN SCHINNERER 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	2086S0102X	Surgical Critical Care Physician	34358	OK
2	2086S0127X	Trauma Surgery Physician	34358	OK
3	208600000X	Surgery Physician	33039	AL

General Provider Information

NPI Number	:	1356608418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIC ALAN SCHINNERER M.D.

Provider Business Mailing Address
First Line	:	1919 S WHEELING AVE STE 606
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74104-5635
Country	:	US
Telephone Number	:	918-748-7676
Fax Number	:	918-403-6340

Provider Business Practice Location Address
First Line	:	1919 S WHEELING AVE STE 606
Second Line	:
City	:	TULSA
State	:	OK
Zip	:	74104-5635
Country	:	US
Telephone Number	:	918-748-7676
Fax Number	:	918-403-6340

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

Provider Enumeration Date	:	04/13/2012
Last Update Date	:	09/14/2021

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