Provider Demographics
NPI:1730145285
Name:SCHNEIDER, JOHN R (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:SCHNEIDER
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 1:1173 PIN OAK CIR
Mailing Address - Street 2:
Mailing Address - City:BRENTWOOD
Mailing Address - State:TN
Mailing Address - Zip Code:37027-8903
Mailing Address - Country:US
Mailing Address - Phone:615-410-4990
Mailing Address - Fax:615-410-4250
Practice Address - Street 1:2548 RIDEOUT LN
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128
Practice Address - Country:US
Practice Address - Phone:615-410-4990
Practice Address - Fax:615-410-4250
Is Sole Proprietor?:No
Enumeration Date:2006-04-25
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN458932084P2900X, 208VP0000X, 2084N0400X, 208VP0014X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
103I130260OtherMEDICARE PTAN
TN1519551Medicaid
TN45893OtherSTATE LICENSE NUMBER