Individual
DR. JEFFREY E SCHULTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
6060 ROCKSIDE WOODS BLVD N, STE 110, INDEPENDENCE, OH 44131-7303
(216) 581-8484
(216) 662-5445
Mailing address
6060 ROCKSIDE WOODS BLVD N, STE 110, INDEPENDENCE, OH 44131-7303
(216) 581-8484
(216) 662-5445
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3146T157
OH
152WC0802X
Corneal and Contact Management Optometrist
3146T157
OH
152WP0200X
Pediatric Optometrist
3146T157
OH
152WX0102X
Occupational Vision Optometrist
3146T157
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000130192
BC/BS
OH
01
—
000000164988
ANTHEM BC/BS
OH
01
—
0004619475
AETNA PIN
OH
05
—
0277123
—
OH
01
—
0348410001
ADMINISTAR FEDERAL ID #
OH
01
—
0413561
MEDICARE ID
OH
01
—
0470094-01-8
UNEMPLOYMENT
OH
01
—
34-1312900-00
WORKERS COMPENSATION
OH
01
—
791580936
MEDICARE ID
OH
01
—
9270432
MEDICARE PROVIDER NUMBER
OH
Enumeration date
06/09/2005
Last updated
10/09/2014
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