| James L Schutzenhofer Md Llc | |
|
1050 Martin Luther King Drive Centralia IL 62801 | |
| (618) 545-1705 | |
| (618) 545-1703 |
| Full Name | James L Schutzenhofer Md Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1050 Martin Luther King Drive, Centralia, Illinois |
| Authorized Official Name and Position | James Louis Schutzenhofer (MD) |
| Authorized Official Contact | 6185451705 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| James L Schutzenhofer Md Llc 1050 Martin Luther King Drive Centralia IL 62801 Ph: (618) 545-1705 | James L Schutzenhofer Md Llc 1050 Martin Luther King Drive Centralia IL 62801 Ph: (618) 545-1705 |
| NPI Number | 1861423659 |
|---|---|
| Provider Enumeration Date | 07/06/2006 |
| Last Update Date | 08/15/2007 |
| Medicare PECOS PAC ID | 9830143957 |
|---|---|
| Medicare Enrollment ID | O20050310000690 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1861423659 | NPI | - | NPPES |
| 06132002 | Other | IL | BLUE SHIELD |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | James L Schutzenhofer |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1851392229 PECOS PAC ID: 5193779221 Enrollment ID: I20050428000106 |
| Provider Name | Karla Anne Schutzenhofer |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1902172372 PECOS PAC ID: 0840453940 Enrollment ID: I20120530000551 |
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