Provider Demographics
NPI:1750310371
Name:SCHMAKEL, JEFFREY G (OD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:G
Last Name:SCHMAKEL
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2237 KINGSTON DR
Mailing Address - Street 2:
Mailing Address - City:MAUMEE
Mailing Address - State:OH
Mailing Address - Zip Code:43537-1122
Mailing Address - Country:US
Mailing Address - Phone:419-867-1819
Mailing Address - Fax:
Practice Address - Street 1:3454 OAK ALLEY CT
Practice Address - Street 2:STE 202
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43606-1370
Practice Address - Country:US
Practice Address - Phone:419-578-0057
Practice Address - Fax:419-578-0061
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2009-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3372-T967152W00000X, 152WC0802X, 152WL0500X, 152WP0200X, 152WS0006X, 152WV0400X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WP0200XEye and Vision Services ProvidersOptometristPediatrics
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
No152WV0400XEye and Vision Services ProvidersOptometristVision Therapy
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH341897615OtherTAX ID # OD PRACTICE
OH201624211OtherVIP TAX ID#
OH3372-T967OtherOPTOMETRIC LICENSE#
OH000000141689OtherANTHEM BC/BS ID#
OH03220OtherPARAMOUNT INSURANCE ID#
OH1119160001OtherDMERC ID#
OH116749OtherEYEMED/ECPA ID #
OH1119160001OtherDMERC ID#
OH341897615OtherTAX ID # OD PRACTICE