Provider Demographics
NPI:1144252776
Name:SCHMIDT, WILLIAM R II (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:R
Last Name:SCHMIDT
Suffix:II
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:PO BOX 776351
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60677-6351
Mailing Address - Country:US
Mailing Address - Phone:502-588-9490
Mailing Address - Fax:502-272-5116
Practice Address - Street 1:6420 DUTCHMANS PKWY
Practice Address - Street 2:SUITE 200
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40205-3372
Practice Address - Country:US
Practice Address - Phone:502-891-8300
Practice Address - Fax:502-891-8338
Is Sole Proprietor?:No
Enumeration Date:2006-07-06
Last Update Date:2021-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY30839207RC0000X, 207RI0011X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000057080QOtherHUMANA- CARDIOTHORACIC SURGERY OF LOUISVILLE
KY1056154OtherPASSPORT PIN
IN200083820AMedicaid
KY000000044899OtherANTHEM PIN
KY64308398Medicaid
KY50031167OtherPASSPORT- CARDIOTHORACIC SURGERY OF LOUISVILLE
IN200083820FMedicaid
KY2433845000OtherPASSPORT ADVANTAGE PIN
KY000000693046OtherANTHEM- CARDIOTHORACIC SURGERY OF LOUISVILLE
KYP00889593OtherRAILROAD MEDICARE
KY1271826Medicare ID - Type Unspecified
KY0558202Medicare ID - Type Unspecified
KY00059005Medicare PIN
KY0259822Medicare ID - Type Unspecified
KY2433845000OtherPASSPORT ADVANTAGE PIN
KY0368206Medicare ID - Type Unspecified
IN200083820AMedicaid
IN200083820FMedicaid
KYP400031659Medicare PIN
KY060028929Medicare PIN