Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208100000X | Physical Medicine & Rehabilitation Doctor | ME115646 | FL |
Y | 2081P2900X | Pain Medicine | ME115646 | FL |
NPI | 1376740191 |
---|---|
Provider Name | Dr. Scott Nelson Schimpff |
First Address | Jacksonville, FL 32244-5596 |
Second Address | Orange Park, FL 32073-4521 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2007 |
Last Update Date | 18/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009034700 | (05) | FL |
1376740191 | (05) | VA |
14QT4 | FLORIDA BLUE (01) | FL |
9996062 | ANTHEM, BC BS (01) | VA |