Provider Demographics
NPI:1235110909
Name:SCHREMMER, TYLER L (OD)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:L
Last Name:SCHREMMER
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 1:801 N PINE ST
Mailing Address - Street 2:
Mailing Address - City:HOISINGTON
Mailing Address - State:KS
Mailing Address - Zip Code:67544-1847
Mailing Address - Country:US
Mailing Address - Phone:620-653-2749
Mailing Address - Fax:620-653-4508
Practice Address - Street 1:801 N PINE ST
Practice Address - Street 2:
Practice Address - City:HOISINGTON
Practice Address - State:KS
Practice Address - Zip Code:67544-1847
Practice Address - Country:US
Practice Address - Phone:620-653-2749
Practice Address - Fax:620-653-4508
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1409-3152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS410047431OtherRAILROAD MEDICARE
KS100327830CMedicaid
KS650864OtherBCBS
KS650864OtherBCBS
KSU45132Medicare UPIN
KS4324040001Medicare NSC