Provider Demographics
NPI:1487673703
Name:SCHNEIDER, JOSEPH F JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:F
Last Name:SCHNEIDER
Suffix:JR
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 1:6435 W JEFFERSON BLVD
Mailing Address - Street 2:#202
Mailing Address - City:FORT WAYNE
Mailing Address - State:IN
Mailing Address - Zip Code:46804-6203
Mailing Address - Country:US
Mailing Address - Phone:256-755-3708
Mailing Address - Fax:
Practice Address - Street 1:6932 WOODCROFT LN
Practice Address - Street 2:
Practice Address - City:FORT WAYNE
Practice Address - State:IN
Practice Address - Zip Code:46804-2827
Practice Address - Country:US
Practice Address - Phone:260-432-9532
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2023-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00013294174400000X
IN01064794174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051540106OtherBLUE CROSS BLUE SHIELD AL
AL009935131Medicaid
IN000000597314OtherBLUE CROSS BLUE SHIELD IN
AL51542427OtherBLUE CROSS BLUE SHIELD AL
AL920005830OtherRR MEDICARE
ALH690OtherMEDICARE
IN200929390Medicaid
ALK065OtherMEDICARE
OH2932929Medicaid
AL51001135OtherBLUE CROSS BLUE SHIELD AL
AL51002589OtherBUE CROSS BLUE SHIELD AL
AL529500990Medicaid
AL51002589OtherBUE CROSS BLUE SHIELD AL
AL051540106OtherBLUE CROSS BLUE SHIELD AL
OH2932929Medicaid