Provider Demographics
NPI:1174668388
Name:SCHOELKOPF, LAWRENCE (MD)
Entity Type:Individual
Prefix:
First Name:LAWRENCE
Middle Name:
Last Name:SCHOELKOPF
Suffix:
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 1:1000 LINCOLN ST
Mailing Address - Street 2:STE 208
Mailing Address - City:FORT MORGAN
Mailing Address - State:CO
Mailing Address - Zip Code:80701-3290
Mailing Address - Country:US
Mailing Address - Phone:970-867-5350
Mailing Address - Fax:970-867-3975
Practice Address - Street 1:1000 LINCOLN ST
Practice Address - Street 2:STE 208
Practice Address - City:FORT MORGAN
Practice Address - State:CO
Practice Address - Zip Code:80701-3290
Practice Address - Country:US
Practice Address - Phone:970-867-5350
Practice Address - Fax:970-867-3975
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2008-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO32842208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC612266OtherANTHEM
CO01328426Medicaid
CO020051543OtherRAILROAD MEDICARE
84158382580701OtherTRICARE
COC454838Medicare PIN
CO01328426Medicaid
COCO301456Medicare PIN
CO020051543OtherRAILROAD MEDICARE