Provider Demographics
NPI:1982680831
Name:SCHUSSLER, JEFFREY S (DPM)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:SCHUSSLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2008 ZUNI DR
Mailing Address - Street 2:
Mailing Address - City:LAKE WAYNOKA
Mailing Address - State:OH
Mailing Address - Zip Code:45171-9272
Mailing Address - Country:US
Mailing Address - Phone:513-535-3338
Mailing Address - Fax:
Practice Address - Street 1:7567 CENTRAL PARKE BLVD STE D
Practice Address - Street 2:
Practice Address - City:MASON
Practice Address - State:OH
Practice Address - Zip Code:45040-6852
Practice Address - Country:US
Practice Address - Phone:513-535-3338
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-21
Last Update Date:2022-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH36002251S213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0627718Medicaid
OHT80750Medicare UPIN
OH0566344Medicare ID - Type Unspecified