Provider Demographics
NPI:1669542460
Name:SCHMITZ, MICHAEL W (RPH)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:SCHMITZ
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 CLOVER LN
Mailing Address - Street 2:
Mailing Address - City:WEATHERFORD
Mailing Address - State:OK
Mailing Address - Zip Code:73096-9322
Mailing Address - Country:US
Mailing Address - Phone:580-774-2816
Mailing Address - Fax:
Practice Address - Street 1:101 W MAIN ST
Practice Address - Street 2:
Practice Address - City:WEATHERFORD
Practice Address - State:OK
Practice Address - Zip Code:73096-4939
Practice Address - Country:US
Practice Address - Phone:580-772-2781
Practice Address - Fax:580-772-2764
Is Sole Proprietor?:No
Enumeration Date:2006-11-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK12045183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist