Basic Information
| Provider Information | |||||||||
| NPI: | 1336108158 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHLEICHER | ||||||||
| FirstName: | JERRY | ||||||||
| MiddleName: | S. | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1928 W STADIUM BLVD | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481034504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349949119 | ||||||||
| FaxNumber: | 7349949120 | ||||||||
| Practice Location | |||||||||
| Address1: | 1928 W STADIUM BLVD | ||||||||
| Address2: | |||||||||
| City: | ANN ARBOR | ||||||||
| State: | MI | ||||||||
| PostalCode: | 481034504 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7349949119 | ||||||||
| FaxNumber: | 7349949120 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/21/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | 4901002409 | MI | Y | Eye and Vision Services Providers | Optometrist |
No ID Information.