Provider Demographics
NPI:1376733394
Name:CHARLES JEFFREY SCHWERTNER, MDPA
Entity Type:Organization
Organization Name:CHARLES JEFFREY SCHWERTNER, MDPA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CHARLES
Authorized Official - Middle Name:J
Authorized Official - Last Name:SCHWERTNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:512-863-4563
Mailing Address - Street 1:1904 RAILROAD ST
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7718
Mailing Address - Country:US
Mailing Address - Phone:512-863-4563
Mailing Address - Fax:512-869-5899
Practice Address - Street 1:1904 RAILROAD ST
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7718
Practice Address - Country:US
Practice Address - Phone:512-863-4563
Practice Address - Fax:512-869-5899
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-26
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK9898207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXDD6873OtherRAILROAD MEDICARE
TXDD6873OtherRAILROAD MEDICARE
TX00776TMedicare PIN