Provider Demographics
NPI:1972536860
Name:JAMES K SCHROEDER MD PC
Entity Type:Organization
Organization Name:JAMES K SCHROEDER MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:K
Authorized Official - Last Name:SCHROEDER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:970-241-9694
Mailing Address - Street 1:425 PATTERSON RD
Mailing Address - Street 2:SUITE 603
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81506-1953
Mailing Address - Country:US
Mailing Address - Phone:970-241-9694
Mailing Address - Fax:970-242-5021
Practice Address - Street 1:425 PATTERSON RD
Practice Address - Street 2:SUITE 603
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81506-1953
Practice Address - Country:US
Practice Address - Phone:970-241-9694
Practice Address - Fax:970-242-5021
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO267562080P0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080P0202XAllopathic & Osteopathic PhysiciansPediatricsPediatric CardiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO36539724Medicaid
CO36539724Medicaid