Provider Demographics
NPI:1306535976
Name:SCHMIEDEL, ISAAC LELAND (PA-C)
Entity type:Individual
Prefix:MR
First Name:ISAAC
Middle Name:LELAND
Last Name:SCHMIEDEL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14321 NE 23RD ST
Mailing Address - Street 2:
Mailing Address - City:CHOCTAW
Mailing Address - State:OK
Mailing Address - Zip Code:73020-8624
Mailing Address - Country:US
Mailing Address - Phone:405-342-0255
Mailing Address - Fax:405-610-6960
Practice Address - Street 1:14321 NE 23RD ST
Practice Address - Street 2:
Practice Address - City:CHOCTAW
Practice Address - State:OK
Practice Address - Zip Code:73020-8624
Practice Address - Country:US
Practice Address - Phone:405-342-0255
Practice Address - Fax:405-610-6960
Is Sole Proprietor?:No
Enumeration Date:2023-05-01
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK5044363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant