MEDICARE: SAMUEL H. SCHMID O.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	152W00000X	Optometrist	1115	OK

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1548200108	OTHER	OK	BLUE CROSS BLUE SHIELD
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1790944411
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAMUEL H. SCHMID O.D.

Provider Business Mailing Address
First Line	:	1408 W BRITTON RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-1316
Country	:	US
Telephone Number	:	405-848-3619
Fax Number	:	405-848-3646

Provider Business Practice Location Address
First Line	:	1408 W BRITTON RD
Second Line	:
City	:	OKLAHOMA CITY
State	:	OK
Zip	:	73114-1316
Country	:	US
Telephone Number	:	405-848-3619
Fax Number	:	405-848-3646

Authorized Official
Title or Position	:	OWNER
Name	:	SAMUEL H SCHMID
Credential	:	O.D.
Telephone Number	:	405-848-3619

Provider Enumeration Date	:	06/06/2008
Last Update Date	:	06/06/2008

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