Provider Demographics
NPI:1457553869
Name:GEORGE SCHROEDER, M.D., P.A.
Entity type:Organization
Organization Name:GEORGE SCHROEDER, M.D., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:T
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:501-225-4488
Mailing Address - Street 1:9800 LILE DR STE 301
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6230
Mailing Address - Country:US
Mailing Address - Phone:501-225-4488
Mailing Address - Fax:501-225-9299
Practice Address - Street 1:9800 LILE DR STE 301
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6230
Practice Address - Country:US
Practice Address - Phone:501-225-4488
Practice Address - Fax:501-225-9299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2009-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR1935207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR104847002Medicaid
AR104847002Medicaid
ARD0489Medicare UPIN