Provider Demographics
NPI:1881681864
Name:SCHMITZ, JAMES L (DO)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:L
Last Name:SCHMITZ
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1006 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:AR
Mailing Address - Zip Code:72933-9388
Mailing Address - Country:US
Mailing Address - Phone:479-965-7702
Mailing Address - Fax:479-965-2180
Practice Address - Street 1:1006 E MAIN ST
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:AR
Practice Address - Zip Code:72933-9388
Practice Address - Country:US
Practice Address - Phone:479-965-7702
Practice Address - Fax:479-965-2180
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-04
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN8432207Q00000X, 261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5G612OtherMEDICARE-PTAN
AR5J293OtherMEDICARE-BCBS
AR184001002Medicaid
AR5G612OtherMEDICARE-PTAN