Basic Information
| Provider Information | |||||||||
| NPI: | 1881681864 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCHMITZ | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | L | ||||||||
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| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1006 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729339388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4799657702 | ||||||||
| FaxNumber: | 4799652180 | ||||||||
| Practice Location | |||||||||
| Address1: | 1006 E MAIN ST | ||||||||
| Address2: | |||||||||
| City: | CHARLESTON | ||||||||
| State: | AR | ||||||||
| PostalCode: | 729339388 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4799657702 | ||||||||
| FaxNumber: | 4799652180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2005 | ||||||||
| LastUpdateDate: | 10/26/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | N8432 | AR | N | Allopathic & Osteopathic Physicians | Family Medicine | 261QP2300X | N8432 | AR | Y | Ambulatory Health Care Facilities | Clinic/Center | Primary Care |
ID Information
| ID | Type | State | Issuer | Description | 5G612 | 01 | AR | MEDICARE-PTAN | OTHER | 5J293 | 01 | AR | MEDICARE-BCBS | OTHER | 184001002 | 05 | AR | MEDICAID |