Provider Demographics
NPI:1790759074
Name:SCHMITT, JAMES L (OD)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:SCHMITT
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 1:2214 STATE ROUTE 405
Mailing Address - Street 2:
Mailing Address - City:MUNCY
Mailing Address - State:PA
Mailing Address - Zip Code:17756-6530
Mailing Address - Country:US
Mailing Address - Phone:570-546-6129
Mailing Address - Fax:570-546-7689
Practice Address - Street 1:2214 STATE ROUTE 405
Practice Address - Street 2:
Practice Address - City:MUNCY
Practice Address - State:PA
Practice Address - Zip Code:17756-6530
Practice Address - Country:US
Practice Address - Phone:570-546-6129
Practice Address - Fax:570-546-7689
Is Sole Proprietor?:No
Enumeration Date:2006-02-14
Last Update Date:2008-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000148152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASC11057Medicare ID - Type Unspecified