Provider Demographics
NPI:1558344507
Name:SCHULTZ, KARL DANIEL JR (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:DANIEL
Last Name:SCHULTZ
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:PO BOX 658
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30503-0658
Mailing Address - Country:US
Mailing Address - Phone:770-718-1122
Mailing Address - Fax:770-533-4786
Practice Address - Street 1:1240 JESSE JEWELL PKWY SE
Practice Address - Street 2:STE 300
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3862
Practice Address - Country:US
Practice Address - Phone:770-534-7200
Practice Address - Fax:678-450-3778
Is Sole Proprietor?:No
Enumeration Date:2005-11-23
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA037676173000000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
No173000000XOther Service ProvidersLegal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA799507418DMedicaid
GA52053507OtherBCBS
GA799507418CMedicaid
GAP00837347OtherRAILROAD MEDICARE
GA01354000OtherAMERIGROUP
GA372241OtherWELLCARE
GAP00837347OtherRAILROAD MEDICARE
GA372241OtherWELLCARE