Provider Demographics
NPI:1992755383
Name:SCHOEDINGER, GEORGE R III (MD)
Entity type:Individual
Prefix:
First Name:GEORGE
Middle Name:R
Last Name:SCHOEDINGER
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 RAYMOND DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CHARLES
Mailing Address - State:MO
Mailing Address - Zip Code:63301-4872
Mailing Address - Country:US
Mailing Address - Phone:636-946-2244
Mailing Address - Fax:366-946-6975
Practice Address - Street 1:2621 RAYMOND DR
Practice Address - Street 2:
Practice Address - City:SAINT CHARLES
Practice Address - State:MO
Practice Address - Zip Code:63301-4872
Practice Address - Country:US
Practice Address - Phone:636-946-2244
Practice Address - Fax:636-946-6975
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2021-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR2700207X00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO200021213OtherRAILROAD MEDICARE
MO42664OtherGROUP HEALTH PLAN
MO101361OtherHEALTHLINK
MO18055OtherBLUE CROSS BLUE SHIELD
MO4000966OtherAETNA
MO3437623002OtherCIGNA
MO201356102Medicaid