Doctor Name: | MRS. CAROL SUE SCHMIDT |
NPI Number: | 1326030891 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | P.A. |
License Number: | PA475 |
Business Practice Address: | 301 J T Stites Blvd Sallisaw, OK - 749559302 |
Business Phone Number: | 9187759150 |
Business Fax Number: | |
Mailing Address: | 825 South Kerr Bvld, SALLISAW |
State: | OK |
Postal Code: | 74955 |
Phone Number: | 9187760263 |
Fax Number: | |
NPI Enumeration Date: | 08/19/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA475 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |