Provider Demographics
NPI:1528023512
Name:SCHMITT, COLLEEN MACLIN (MD)
Entity type:Individual
Prefix:
First Name:COLLEEN
Middle Name:MACLIN
Last Name:SCHMITT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8051 THUNDER FARMS TRL
Mailing Address - Street 2:
Mailing Address - City:OOLTEWAH
Mailing Address - State:TN
Mailing Address - Zip Code:37363-7146
Mailing Address - Country:US
Mailing Address - Phone:423-645-5889
Mailing Address - Fax:
Practice Address - Street 1:8051 THUNDER FARMS TRL
Practice Address - Street 2:
Practice Address - City:OOLTEWAH
Practice Address - State:TN
Practice Address - Zip Code:37363-7146
Practice Address - Country:US
Practice Address - Phone:423-645-5889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-20
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN25672207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3084154Medicaid
TN3084154Medicaid
TN3084154Medicare ID - Type Unspecified