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NPI Code Detail

MEDICARE: DAVID D ESCOBAR P.T.

MEDICARE:   DAVID D ESCOBAR  P.T.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225100000XPhysical Therapist002008KY

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2650019563OTHERKYRR MEDICARE #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11174914OTHERKYCHA PROVIDER #
3000000179369OTHERKYBLUE CROSS BLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1013003029
Entity Type Code : Individual
Provider Name (Legal Business Name) : DAVID D ESCOBAR P.T.
Provider Business Mailing Address
First Line : 117 TRADEPARK DR
Second Line :
City : SOMERSET
State : KY
Zip : 42503-3428
Country : US
Telephone Number : 606-678-5708
Fax Number : 606-678-4336
Provider Business Practice Location Address
First Line : 117 TRADEPARK DR
Second Line :
City : SOMERSET
State : KY
Zip : 42503-3428
Country : US
Telephone Number : 606-678-5708
Fax Number : 606-678-4336
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/05/2006
Last Update Date : 07/08/2007

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Directions to “ DAVID D ESCOBAR P.T.” Practice Location

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