Individual
JAY M SCHMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
115 W 2ND ST, GRACEVILLE, MN 56240-4803
(320) 748-7243
(320) 748-8204
Mailing address
115 W 2ND ST, GRACEVILLE, MN 56240-4803
(320) 748-7243
(320) 748-8204
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
46406
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
166K7SC
BLUE CROSS BLUE SHIELD MN
MN
05
—
812980100
—
MN
Enumeration date
07/19/2005
Last updated
11/04/2010
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