Scott, Jack D

Scott, Jack D is an individual health care provider with primary practice located at 1600 Sw Archer Rd , Gainesville FL 32610-3003. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / Emergency Medical Services. Allopathic & Osteopathic Physicians / Emergency Medicine is his primary health care specialty. Scott, Jack D can be contacted via phone (352) 265-5911.

Contact Information

Primary practice address
1600 Sw Archer Rd Gainesville FL 32610-3003
Phone: (352) 265-5911
Fax: (352) 265-5606
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01072522A Indiana
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X ME0069637 Florida
Allopathic & Osteopathic Physicians / Emergency Medical Services 207PE0004X 01072522A Indiana
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X ME69637 Florida

Profile Details

NPI number 1629056189
LBN Legal business name Scott, Jack D
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 5th, 2006
Last updated Oct 13th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1629056189 NPPES
Florida Other 28263 BCBS
Florida Other P00162734 BCBS
Florida MEDICAID 250686600 BCBS

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