Provider Demographics
NPI:1508982166
Name:CAMERON S SCHAEFFER MD PSC
Entity Type:Organization
Organization Name:CAMERON S SCHAEFFER MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:CAMERON
Authorized Official - Middle Name:SHERWOOD
Authorized Official - Last Name:SCHAEFFER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:859-275-5437
Mailing Address - Street 1:1760 NICHOLASVILLE RD
Mailing Address - Street 2:SUITE 601
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-1471
Mailing Address - Country:US
Mailing Address - Phone:859-275-5437
Mailing Address - Fax:859-275-5434
Practice Address - Street 1:1760 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 601
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-1471
Practice Address - Country:US
Practice Address - Phone:859-275-5437
Practice Address - Fax:859-275-5434
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-22
Last Update Date:2014-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
2088P0231X
KY363LF0000X, 363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2088P0231XAllopathic & Osteopathic PhysiciansUrologyPediatric UrologyGroup - Multi-Specialty
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Multi-Specialty
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY6593656900Medicaid
KY6593656900Medicaid
KY6413Medicare PIN