Provider Demographics
NPI:1497804181
Name:EARL C. SCHEIDLER ,DO., INC.
Entity Type:Organization
Organization Name:EARL C. SCHEIDLER ,DO., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:S
Authorized Official - Last Name:SCHEIDLER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:513-563-6222
Mailing Address - Street 1:11043 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45241-2678
Mailing Address - Country:US
Mailing Address - Phone:513-563-1737
Mailing Address - Fax:513-563-2476
Practice Address - Street 1:11043 MAIN ST
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45241-2678
Practice Address - Country:US
Practice Address - Phone:513-563-6222
Practice Address - Fax:513-563-2476
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-10
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAS2790930207Q00000X, 207QS0010X, 207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports MedicineGroup - Multi-Specialty
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0565295Medicaid
OHCL6719OtherGROUP RR MCR#
OHCL6719OtherGROUP RR MCR#