Provider Demographics
NPI:1881785616
Name:SCHULTZ, THOMAS E (OD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:E
Last Name:SCHULTZ
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 1:11700 PARKWAY DR
Mailing Address - Street 2:
Mailing Address - City:IRWIN
Mailing Address - State:PA
Mailing Address - Zip Code:15642-2011
Mailing Address - Country:US
Mailing Address - Phone:724-864-4323
Mailing Address - Fax:724-864-4323
Practice Address - Street 1:11700 PARKWAY DR
Practice Address - Street 2:
Practice Address - City:IRWIN
Practice Address - State:PA
Practice Address - Zip Code:15642-2011
Practice Address - Country:US
Practice Address - Phone:724-864-4323
Practice Address - Fax:724-864-4323
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001614152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist