Provider Demographics
NPI:1649274051
Name:SCHOLZ, CHRIS M (OD)
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:M
Last Name:SCHOLZ
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 1:1893 N ISETT AVE
Mailing Address - Street 2:
Mailing Address - City:MUSCATINE
Mailing Address - State:IA
Mailing Address - Zip Code:52761-9747
Mailing Address - Country:US
Mailing Address - Phone:563-263-4744
Mailing Address - Fax:
Practice Address - Street 1:1700 PARK AVE
Practice Address - Street 2:
Practice Address - City:MUSCATINE
Practice Address - State:IA
Practice Address - Zip Code:52761-5434
Practice Address - Country:US
Practice Address - Phone:563-263-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2008-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA2138152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0193037Medicaid
IA3193037Medicaid
IAI1162Medicare PIN
IAI1157Medicare PIN
IA0193037Medicaid
IA49312Medicare PIN