Provider Demographics
NPI:1184076739
Name:SCHMIDLKOFER, JAMES (RN)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:SCHMIDLKOFER
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 400
Mailing Address - Street 2:
Mailing Address - City:OKMULGEE
Mailing Address - State:OK
Mailing Address - Zip Code:74447-0400
Mailing Address - Country:US
Mailing Address - Phone:918-623-1424
Mailing Address - Fax:918-623-1066
Practice Address - Street 1:309 N 14TH ST
Practice Address - Street 2:
Practice Address - City:OKEMAH
Practice Address - State:OK
Practice Address - Zip Code:74859-2028
Practice Address - Country:US
Practice Address - Phone:918-623-1424
Practice Address - Fax:918-623-1066
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2016-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK56110163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse