Provider Demographics
NPI:1316080567
Name:SCHUMACHER, JAMES L (DMD)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:SCHUMACHER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4201 ROOSEVELT BLVD
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32210-2027
Mailing Address - Country:US
Mailing Address - Phone:904-388-3559
Mailing Address - Fax:904-389-8562
Practice Address - Street 1:4201 ROOSEVELT BLVD
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32210-2027
Practice Address - Country:US
Practice Address - Phone:904-388-3559
Practice Address - Fax:904-389-8562
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL101521223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice