Provider Demographics
NPI:1588841704
Name:DR. THOMAS J SCHAPERKOTTER
Entity Type:Organization
Organization Name:DR. THOMAS J SCHAPERKOTTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:SCHAPERKOTTER
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:231-547-4486
Mailing Address - Street 1:6795 US 31 HWY S
Mailing Address - Street 2:
Mailing Address - City:CHARLEVOIX
Mailing Address - State:MI
Mailing Address - Zip Code:49720-9701
Mailing Address - Country:US
Mailing Address - Phone:231-547-4486
Mailing Address - Fax:231-547-6668
Practice Address - Street 1:6795 US 31 HWY S
Practice Address - Street 2:
Practice Address - City:CHARLEVOIX
Practice Address - State:MI
Practice Address - Zip Code:49720-9701
Practice Address - Country:US
Practice Address - Phone:231-547-4486
Practice Address - Fax:231-547-6668
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-30
Last Update Date:2013-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4901002508152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0834270001Medicare NSC