Provider Demographics
NPI:1598826968
Name:SCHOEN, JEFFREY A (DPM)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:A
Last Name:SCHOEN
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 W MONROE ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32204-1177
Mailing Address - Country:US
Mailing Address - Phone:904-384-2240
Mailing Address - Fax:904-384-6055
Practice Address - Street 1:1635 EAGLE HARBOR PKWY
Practice Address - Street 2:SUITE 5
Practice Address - City:ORANGE PARK
Practice Address - State:FL
Practice Address - Zip Code:32003-4827
Practice Address - Country:US
Practice Address - Phone:904-384-2240
Practice Address - Fax:904-385-7777
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2011-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCP0596213E00000X
VA0101100862213E00000X
MD01278213E00000X
FLPO3476213ES0103X, 213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
T68106Medicare UPIN
011800M92Medicare ID - Type Unspecified