Provider Demographics
NPI:1396738043
Name:SCHULTZ, RICHARD L (MD)
Entity type:Individual
Prefix:
First Name:RICHARD
Middle Name:L
Last Name:SCHULTZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 OAK RIDGE TPKE
Mailing Address - Street 2:SUITE C-100
Mailing Address - City:OAK RIDGE
Mailing Address - State:TN
Mailing Address - Zip Code:37830-6957
Mailing Address - Country:US
Mailing Address - Phone:865-483-2288
Mailing Address - Fax:865-482-4400
Practice Address - Street 1:800 OAK RIDGE TPKE
Practice Address - Street 2:SUITE C-100
Practice Address - City:OAK RIDGE
Practice Address - State:TN
Practice Address - Zip Code:37830-6957
Practice Address - Country:US
Practice Address - Phone:865-483-2288
Practice Address - Fax:865-482-4400
Is Sole Proprietor?:No
Enumeration Date:2005-08-29
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
KY27866207Y00000X
TN8288207YX0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY00000252843OtherATHEM BLUE CROSS
TN3028798OtherBLUE CROSS BLUE SHIELD
TN3001269Medicaid
TN62089728901OtherUHC RIVER VALLEY
KY64772809Medicaid
KYC10004OtherCUMBERLAND HEALTHCARE
TN4034805OtherAETNA
KY4531OtherCHA
KY620897289001OtherBLUEGRASS FAMILY HEALTH
TN100012042OtherPHP TENNCARE
KY620897289001OtherBLUEGRASS FAMILY HEALTH
KY4531OtherCHA
KY00000252843OtherATHEM BLUE CROSS