Provider Demographics
NPI:1366429797
Name:SCHEPER, TONI J (OD)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:J
Last Name:SCHEPER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:TONI
Other - Middle Name:
Other - Last Name:SCHEPER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:17411 IONIA PATH
Mailing Address - Street 2:
Mailing Address - City:LAKEVILLE
Mailing Address - State:MN
Mailing Address - Zip Code:55044-5624
Mailing Address - Country:US
Mailing Address - Phone:952-270-1907
Mailing Address - Fax:612-808-5023
Practice Address - Street 1:1063 BURNSVILLE CTR
Practice Address - Street 2:
Practice Address - City:BURNSVILLE
Practice Address - State:MN
Practice Address - Zip Code:55306
Practice Address - Country:US
Practice Address - Phone:952-435-8821
Practice Address - Fax:612-808-5023
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2018-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2331152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN420525100Medicaid
MN410003723OtherMEDICARE ID