Provider Demographics
NPI:1912540808
Name:SCHMIDT, CLAIRE KEATON (PA-C)
Entity Type:Individual
Prefix:
First Name:CLAIRE
Middle Name:KEATON
Last Name:SCHMIDT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:MADELEINE
Other - Middle Name:CLAIRE
Other - Last Name:KEATON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:5959 S SHERWOOD FOREST BLVD
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70816-6038
Mailing Address - Country:US
Mailing Address - Phone:225-374-1528
Mailing Address - Fax:225-765-9196
Practice Address - Street 1:8300 CONSTANTIN BLVD
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70809-3489
Practice Address - Country:US
Practice Address - Phone:225-374-1528
Practice Address - Fax:225-374-1611
Is Sole Proprietor?:No
Enumeration Date:2019-10-23
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXPA130922086S0120X, 363AS0400X
LA321005363AS0400X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No2086S0120XAllopathic & Osteopathic PhysiciansSurgeryPediatric Surgery
No363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical