Provider Demographics
NPI:1285949495
Name:SCHMITZ FAMILY PRACTICE AND RURAL HEALTH, PLLC
Entity type:Organization
Organization Name:SCHMITZ FAMILY PRACTICE AND RURAL HEALTH, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHMITZ
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:479-965-7702
Mailing Address - Street 1:1006 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:AR
Mailing Address - Zip Code:72933-9388
Mailing Address - Country:US
Mailing Address - Phone:479-965-7702
Mailing Address - Fax:479-965-2180
Practice Address - Street 1:1006 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:AR
Practice Address - Zip Code:72933-9388
Practice Address - Country:US
Practice Address - Phone:479-965-7702
Practice Address - Fax:479-965-2180
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-08-11
Last Update Date:2010-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5G612OtherMEDICARE PTAN
AR184001002Medicaid
AR5J293OtherMEDICARE - BCBS
ARF73681Medicare UPIN