Provider Demographics
NPI:1366749517
Name:SCHMIDT, JESSE JAMES (PHARMD)
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:JAMES
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PSC 1005, BOX 110185
Mailing Address - Street 2:
Mailing Address - City:FPO
Mailing Address - State:AA
Mailing Address - Zip Code:34009
Mailing Address - Country:US
Mailing Address - Phone:757-458-2071
Mailing Address - Fax:
Practice Address - Street 1:PSC 1005
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AA
Practice Address - Zip Code:34009
Practice Address - Country:US
Practice Address - Phone:757-458-2071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-24
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK14895183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist