Provider Demographics
NPI:1154454429
Name:SCHNEIDER, LAWRENCE G (OD)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:G
Last Name:SCHNEIDER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6834 TYLERSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-1416
Mailing Address - Country:US
Mailing Address - Phone:513-779-3933
Mailing Address - Fax:513-779-6760
Practice Address - Street 1:6834 TYLERSVILLE RD
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-1416
Practice Address - Country:US
Practice Address - Phone:513-779-3933
Practice Address - Fax:513-779-6760
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-14
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3001152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0183377Medicaid
OH0183377Medicaid