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NPI Code Detail

MEDICARE: MR. SCOTT E. CACKLER II PA-C

MEDICARE: MR. SCOTT E. CACKLER II PA-C
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
1363AS0400XSurgical Physician Assistant50.002816OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1417134628
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SCOTT E. CACKLER II PA-C
Provider Business Mailing Address
First Line : PO BOX 7527
Second Line :
City : DUBLIN
State : OH
Zip : 43017-0727
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 285 E STATE ST STE 400
Second Line :
City : COLUMBUS
State : OH
Zip : 43215-4368
Country : US
Telephone Number : 614-533-5000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/30/2008
Last Update Date : 01/25/2022

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