Provider Demographics
NPI:1932102613
Name:SCHMITT, EUGENE H III (MD)
Entity Type:Individual
Prefix:DR
First Name:EUGENE
Middle Name:H
Last Name:SCHMITT
Suffix:III
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 1:704 S WEBSTER AVE
Mailing Address - Street 2:STE 401
Mailing Address - City:GREEN BAY
Mailing Address - State:WI
Mailing Address - Zip Code:54301-3531
Mailing Address - Country:US
Mailing Address - Phone:920-432-7000
Mailing Address - Fax:920-432-7451
Practice Address - Street 1:704 S WEBSTER AVE
Practice Address - Street 2:STE 401
Practice Address - City:GREEN BAY
Practice Address - State:WI
Practice Address - Zip Code:54301-3531
Practice Address - Country:US
Practice Address - Phone:920-432-7000
Practice Address - Fax:920-432-7451
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-05-24
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI26875-020208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI30681700Medicaid
WI26875-020OtherMEDICAL LICENSE NUMBER
AS8257164OtherDEA LICENSE NUMBER
WI30681700Medicaid