Individual
JEREMY SCHADEWALD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
650 JOEL DR, FORT CAMPBELL, KY 42223-5318
(270) 798-8400
Mailing address
1150A DENT CT, FORT CAMPBELL, KY 42223-3404
(330) 388-5787
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
11/05/2020
Last updated
11/05/2020
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