Provider Demographics
NPI:1093978686
Name:SCHULZ, JAMIE LYNN (DO)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:LYNN
Last Name:SCHULZ
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:525 ALEXANDRIA PIKE
Mailing Address - Street 2:STE 300
Mailing Address - City:SOUTHGATE
Mailing Address - State:KY
Mailing Address - Zip Code:41071-3290
Mailing Address - Country:US
Mailing Address - Phone:859-781-2210
Mailing Address - Fax:859-781-0289
Practice Address - Street 1:525 ALEXANDRIA PIKE
Practice Address - Street 2:STE 300
Practice Address - City:SOUTHGATE
Practice Address - State:KY
Practice Address - Zip Code:41071-3290
Practice Address - Country:US
Practice Address - Phone:859-781-2210
Practice Address - Fax:859-781-0289
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2012-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY03399207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY7100176040Medicaid
OH0057248Medicaid
KYK011030Medicare PIN