Basic Information
Provider Information
NPI: 1417007519
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: SCHMIEG
FirstName: JOHN
MiddleName: JOSEPH
NamePrefix: DR.
NameSuffix: III
Credential: M.D., PH.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1422 OCTAVIA ST
Address2:  
City: NEW ORLEANS
State: LA
PostalCode: 701154227
CountryCode: US
TelephoneNumber: 6464130079
FaxNumber: 5049882420
Practice Location
Address1: 1430 TULANE AVE
Address2: SL79
City: NEW ORLEANS
State: LA
PostalCode: 701122632
CountryCode: US
TelephoneNumber: 5049885224
FaxNumber: 5049882420
Other Information
ProviderEnumerationDate: 01/11/2007
LastUpdateDate: 09/29/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207ZP0102XMD.204851LAY Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
207ZP0102XMD438660PAN Allopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology

No ID Information.


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