Provider Demographics
NPI:1407182900
Name:CARL S SCHREINER MD PC
Entity Type:Organization
Organization Name:CARL S SCHREINER MD PC
Other - Org Name:ENT ASSOCIATES OF ROSEBURG LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:STURGIS
Authorized Official - Last Name:SCHREINER
Authorized Official - Suffix:IV
Authorized Official - Credentials:MD
Authorized Official - Phone:541-677-3400
Mailing Address - Street 1:2423 NW TROOST ST
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-1706
Mailing Address - Country:US
Mailing Address - Phone:541-677-3400
Mailing Address - Fax:541-677-3405
Practice Address - Street 1:2423 NW TROOST ST
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-1706
Practice Address - Country:US
Practice Address - Phone:541-677-3400
Practice Address - Fax:541-677-3405
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-10-19
Last Update Date:2015-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD21871207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500614886Medicaid
ORR150843Medicare PIN