Provider Demographics
NPI:1649777178
Name:SCHMITT, ALEXANDER JOHN WILSON (PA-C)
Entity Type:Individual
Prefix:
First Name:ALEXANDER
Middle Name:JOHN WILSON
Last Name:SCHMITT
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:132 17TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-0321
Mailing Address - Country:US
Mailing Address - Phone:507-292-7411
Mailing Address - Fax:
Practice Address - Street 1:132 17TH AVE NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-0321
Practice Address - Country:US
Practice Address - Phone:507-292-7411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-04-11
Last Update Date:2024-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12704363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant