Richard Otto Schultz
Individual provider Active NPI Specialist · Egg Harbor, WI
NPI 1659638799 · NPPES record last updated Aug 2, 2026
Key facts
- NPI
- 1659638799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 13963-20 (WI)
- Practice address
- 4487 Granny Smith CT
Egg Harbor, WI 54209-9559 - Phone
- (920) 868-5021
- Fax
- (920) 868-5021
- NPI assigned
- Apr 13, 2012
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 13963-20 | WI | MD | Specialist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 13963-20 | WI | Yes |
| Ophthalmology Physician | 207W00000X | 13963-20 | WI |
Addresses
Primary practice location
4487 Granny Smith CT
Egg Harbor, WI 54209-9559
Mailing address
4487 Granny Smith CT
Egg Harbor, WI 54209-9559
Phone (920) 868-5021
Other names
- Dr. Richard Otto Schultz
Other providers in Egg Harbor, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 2, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.