Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 18002924B | IN |
NPI | 1003967852 |
---|---|
Provider Name | Dr. Stephen K Schlegel |
First Address | Mitchell, IN 47446-1414 |
Second Address | Mitchell, IN 47446-1414 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/01/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U70925 | (02) | IN |