Provider Demographics
NPI:1659391209
Name:SCHULZ, JEFFREY E (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:E
Last Name:SCHULZ
Suffix:
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:SCHNECK MEDICAL CENTER
Mailing Address - Street 2:411 WEST TIPTON STREET
Mailing Address - City:SEYMOUR
Mailing Address - State:IN
Mailing Address - Zip Code:47274-2363
Mailing Address - Country:US
Mailing Address - Phone:812-524-8346
Mailing Address - Fax:812-524-4231
Practice Address - Street 1:SCHNECK MEDICAL CENTER
Practice Address - Street 2:411 WEST TIPTON STREET
Practice Address - City:SEYMOUR
Practice Address - State:IN
Practice Address - Zip Code:47274
Practice Address - Country:US
Practice Address - Phone:812-524-8346
Practice Address - Fax:812-524-4231
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2018-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01038272A208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200003010AMedicaid
IN000000084531OtherANTHEM
IN381610BMedicare ID - Type Unspecified
IN200003010AMedicaid