Provider Demographics
NPI:1497741755
Name:SCHAEFFER, RONNIE LEE (OD)
Entity Type:Individual
Prefix:MR
First Name:RONNIE
Middle Name:LEE
Last Name:SCHAEFFER
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 1:2 W VICTORY WAY
Mailing Address - Street 2:
Mailing Address - City:CRAIG
Mailing Address - State:CO
Mailing Address - Zip Code:81625-2606
Mailing Address - Country:US
Mailing Address - Phone:970-824-8307
Mailing Address - Fax:970-824-8307
Practice Address - Street 1:2 W VICTORY WAY
Practice Address - Street 2:
Practice Address - City:CRAIG
Practice Address - State:CO
Practice Address - Zip Code:81625-2606
Practice Address - Country:US
Practice Address - Phone:970-824-8307
Practice Address - Fax:970-824-8307
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1107152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist