Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | ME60145 | FL |
NPI | 1295794477 |
---|---|
Provider Name | Dr. Jeffrey K Scott |
First Address | Bradenton, FL 34209 |
Second Address | Bradenton, FL 34209 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2006 |
Last Update Date | 01/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
12321Z | PTAN (01) | FL |