Provider Demographics
NPI:1356608418
Name:SCHINNERER, ERIC ALAN (MD)
Entity type:Individual
Prefix:
First Name:ERIC
Middle Name:ALAN
Last Name:SCHINNERER
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 1:1919 S WHEELING AVE STE 606
Mailing Address - Street 2:
Mailing Address - City:TULSA
Mailing Address - State:OK
Mailing Address - Zip Code:74104-5635
Mailing Address - Country:US
Mailing Address - Phone:918-748-7676
Mailing Address - Fax:918-403-6340
Practice Address - Street 1:1919 S WHEELING AVE STE 606
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74104-5635
Practice Address - Country:US
Practice Address - Phone:918-748-7676
Practice Address - Fax:918-403-6340
Is Sole Proprietor?:No
Enumeration Date:2012-04-13
Last Update Date:2021-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK343582086S0102X, 2086S0127X
AL33039208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0127XAllopathic & Osteopathic PhysiciansSurgeryTrauma Surgery
No2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care
No208600000XAllopathic & Osteopathic PhysiciansSurgery