Provider Demographics
NPI:1013920446
Name:SCHOENECKER, CRAIG JEROME (MD)
Entity Type:Individual
Prefix:
First Name:CRAIG
Middle Name:JEROME
Last Name:SCHOENECKER
Suffix:
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 1:129 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:WI
Mailing Address - Zip Code:53098
Mailing Address - Country:US
Mailing Address - Phone:920-262-4800
Mailing Address - Fax:
Practice Address - Street 1:129 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:WI
Practice Address - Zip Code:53098-3384
Practice Address - Country:US
Practice Address - Phone:920-262-4800
Practice Address - Fax:920-262-4813
Is Sole Proprietor?:No
Enumeration Date:2006-08-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI481950202084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry