Provider Demographics
NPI:1760481071
Name:SCHOENGARTH, LOWELL D (MD)
Entity type:Individual
Prefix:
First Name:LOWELL
Middle Name:D
Last Name:SCHOENGARTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:500 N KEENE ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COLUMBIA
Mailing Address - State:MO
Mailing Address - Zip Code:65201-8105
Mailing Address - Country:US
Mailing Address - Phone:573-449-3846
Mailing Address - Fax:573-449-3706
Practice Address - Street 1:500 N KEENE ST
Practice Address - Street 2:SUITE 101
Practice Address - City:COLUMBIA
Practice Address - State:MO
Practice Address - Zip Code:65201-8105
Practice Address - Country:US
Practice Address - Phone:573-449-3846
Practice Address - Fax:573-449-3706
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-19
Last Update Date:2010-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MOR9337207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO201028404Medicaid
MO180012947OtherRAILROAD MEDICARE
MO201028404Medicaid