Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223G0001X | General Practice | 16115 | OH |
Y | 213EG0000X | General Practice | 16115 | OH |
NPI | 1003927732 |
---|---|
Provider Name | Dr. Joseph R Schmidbauer JR. |
First Address | Oregon, OH 43616-2117 |
Second Address | Oregon, OH 43616-2117 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0418480 | (05) | OH |