Provider Demographics
NPI:1689664252
Name:SCHMIDT, FRANK M (PD)
Entity Type:Individual
Prefix:
First Name:FRANK
Middle Name:M
Last Name:SCHMIDT
Suffix:
Gender:M
Credentials:PD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 CHOCTAW CTR
Mailing Address - Street 2:
Mailing Address - City:CHEROKEE VILLAGE
Mailing Address - State:AR
Mailing Address - Zip Code:72529-2701
Mailing Address - Country:US
Mailing Address - Phone:870-856-4696
Mailing Address - Fax:870-856-4658
Practice Address - Street 1:1 CHOCTAW CTR
Practice Address - Street 2:
Practice Address - City:CHEROKEE VILLAGE
Practice Address - State:AR
Practice Address - Zip Code:72529-2701
Practice Address - Country:US
Practice Address - Phone:870-856-4696
Practice Address - Fax:870-856-4658
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARAR20202183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR49906OtherBLUE CROSS/BLUE SHIELD
AR4233360001Medicare ID - Type Unspecified