Basic Information
| Provider Information | |||||||||
| NPI: | 1235151895 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHMITT | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | ELMER | ||||||||
| NamePrefix: | |||||||||
| NameSuffix: | JR. | ||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | COMMUNITY MEMORIAL HOSPITAL | ||||||||
| Address2: | 512 SKYLINE BLVD | ||||||||
| City: | CLOQUET | ||||||||
| State: | MN | ||||||||
| PostalCode: | 557201199 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2188794641 | ||||||||
| FaxNumber: | 3207635749 | ||||||||
| Practice Location | |||||||||
| Address1: | COMMUNITY MEMORIAL HOSPITAL | ||||||||
| Address2: | 512 SKYLINE BLVD | ||||||||
| City: | CLOQUET | ||||||||
| State: | MN | ||||||||
| PostalCode: | 557201199 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2188794641 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/24/2006 | ||||||||
| LastUpdateDate: | 11/06/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 11/06/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Y00000X | 9186 | ND | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | 35044002 | OH | N | Allopathic & Osteopathic Physicians | Otolaryngology | 207Y00000X | 45382 | MN | Y | Allopathic & Osteopathic Physicians | Otolaryngology |
No ID Information.