Provider Demographics
NPI:1033169479
Name:SCHUMACHER, JOHN P (PA,CCP)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:SCHUMACHER
Suffix:
Gender:M
Credentials:PA,CCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 8805
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31908-8805
Mailing Address - Country:US
Mailing Address - Phone:706-596-8200
Mailing Address - Fax:706-571-0207
Practice Address - Street 1:2300 MANCHESTER EXPY
Practice Address - Street 2:STE 1009
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904-6877
Practice Address - Country:US
Practice Address - Phone:706-596-8200
Practice Address - Fax:706-571-0207
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2015-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001143363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA001143OtherSTATE LICENSE
AL156095Medicaid
GA003142832BMedicaid
GA20297I0265OtherMEDICARE PTAN