Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 26193 | CO |
N | 207ND0900X | Dermatopathologist | 26193 | CO |
N | 207NS0135X | Procedural Dermatology | 26193 | CO |
NPI | 1306846746 |
---|---|
Provider Name | Dr. John Joseph Schmidt |
First Address | Pueblo, CO 81003-2622 |
Second Address | Pueblo, CO 81003-2622 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/07/2005 |
Last Update Date | 20/10/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01261932 | (05) | CO |
D24768 | (02) | CO |