Provider Demographics
NPI:1164413225
Name:JOHN SCHNEIDER JR MD PC
Entity Type:Organization
Organization Name:JOHN SCHNEIDER JR MD PC
Other - Org Name:NORTHERN ROCKIES NEURO-SPINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:H
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:406-651-8197
Mailing Address - Street 1:449 MOUNTAIN VIEW ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-2232
Mailing Address - Country:US
Mailing Address - Phone:307-754-4559
Mailing Address - Fax:307-754-7733
Practice Address - Street 1:2877 OVERLAND AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59102-7469
Practice Address - Country:US
Practice Address - Phone:406-651-8197
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-28
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY05777001OtherBLUE CROSS BLUE SHEILD
WY05777001OtherBLUE CROSS BLUE SHEILD