Provider Demographics
NPI:1013009919
Name:SCHMIDT, MYRON C (DC)
Entity Type:Individual
Prefix:
First Name:MYRON
Middle Name:C
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8310 W 151ST ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223
Mailing Address - Country:US
Mailing Address - Phone:913-897-2111
Mailing Address - Fax:913-814-0702
Practice Address - Street 1:8310 W 151ST ST
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66223
Practice Address - Country:US
Practice Address - Phone:913-897-2111
Practice Address - Fax:913-814-0702
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS013625111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS09297015OtherBLUE CROSS BLUE SHIELD
KS0004878Medicare ID - Type Unspecified