Provider Demographics
NPI:1376525568
Name:SCHAUFELE, JULIE A (MD)
Entity Type:Individual
Prefix:MRS
First Name:JULIE
Middle Name:A
Last Name:SCHAUFELE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JULIE
Other - Middle Name:A
Other - Last Name:NAHRGANG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:413 W FOREST LN
Mailing Address - Street 2:
Mailing Address - City:HOBART
Mailing Address - State:OK
Mailing Address - Zip Code:73651-1645
Mailing Address - Country:US
Mailing Address - Phone:580-726-2000
Mailing Address - Fax:580-726-2011
Practice Address - Street 1:413 W FOREST LN
Practice Address - Street 2:
Practice Address - City:HOBART
Practice Address - State:OK
Practice Address - Zip Code:73651-1645
Practice Address - Country:US
Practice Address - Phone:580-726-2000
Practice Address - Fax:580-726-2011
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2013-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK22008207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK100085570AMedicaid
OK248325509Medicare ID - Type Unspecified
H70745Medicare UPIN