Individual
ROY A SCHMIDT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M. D.
Contact information
Practice address
15 STONEBRIDGE BLVD, JACKSON, TN 38305-2042
(731) 660-2056
(731) 661-9092
Mailing address
15 STONEBRIDGE BLVD, JACKSON, TN 38305-2042
(731) 660-2056
(731) 661-9092
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
22099
TN
207L00000X
Anesthesiology Physician
MD22099
TN
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD22099
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000378004
ANTHEM
KY
01
—
030670000
BLACK LUNG
KY
05
—
3380640
—
TN
01
—
50007501
PASSPORT HEALTH PLAN
KY
05
—
64095367
—
KY
01
—
C20829
CUMBERLAND HEALTHCARE INC
KY
Enumeration date
06/07/2006
Last updated
04/18/2019
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