Provider Demographics
NPI:1356313472
Name:SCHLEUTKER, JEFFREY C (OD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:C
Last Name:SCHLEUTKER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8000 E 126TH ST
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46038-1006
Mailing Address - Country:US
Mailing Address - Phone:317-849-9307
Mailing Address - Fax:
Practice Address - Street 1:8000 E 126TH ST
Practice Address - Street 2:
Practice Address - City:FISHERS
Practice Address - State:IN
Practice Address - Zip Code:46038-1006
Practice Address - Country:US
Practice Address - Phone:317-849-9307
Practice Address - Fax:317-849-9307
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2017-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18001937B152W00000X, 152WC0802X, 152WX0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WX0102XEye and Vision Services ProvidersOptometristOccupational Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
INT93950Medicare UPIN