Provider Demographics
NPI:1437374550
Name:MICHAEL J SCHMIDT FACS
Entity type:Organization
Organization Name:MICHAEL J SCHMIDT FACS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHMIDT
Authorized Official - Suffix:
Authorized Official - Credentials:FACS
Authorized Official - Phone:501-315-7808
Mailing Address - Street 1:5 MEDICAL PARK DR
Mailing Address - Street 2:SUITE 308
Mailing Address - City:BENTON
Mailing Address - State:AR
Mailing Address - Zip Code:72015-3729
Mailing Address - Country:US
Mailing Address - Phone:501-315-7808
Mailing Address - Fax:501-315-4888
Practice Address - Street 1:5 MEDICAL PARK DR
Practice Address - Street 2:SUITE 308
Practice Address - City:BENTON
Practice Address - State:AR
Practice Address - Zip Code:72015-3729
Practice Address - Country:US
Practice Address - Phone:501-315-7808
Practice Address - Fax:501-315-4888
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-16
Last Update Date:2008-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARN8431174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty