Provider Demographics
NPI:1093291601
Name:SCHAFER MEDICAL PLLC
Entity Type:Organization
Organization Name:SCHAFER MEDICAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:WILSON
Authorized Official - Last Name:SCHAFER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:580-319-1410
Mailing Address - Street 1:800 ISABEL ST
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73401-5118
Mailing Address - Country:US
Mailing Address - Phone:580-223-5432
Mailing Address - Fax:580-223-6076
Practice Address - Street 1:800 ISABEL ST
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-5118
Practice Address - Country:US
Practice Address - Phone:580-223-5432
Practice Address - Fax:580-223-6076
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-07-17
Last Update Date:2020-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK4352207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty