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NPI Code Detail

MEDICARE: DR. JONATHAN SCOTT QUINBY MD

MEDICARE: DR. JONATHAN SCOTT QUINBY MD
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
1207XX0005XSports Medicine (Orthopaedic Surgery) PhysicianM1300TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
18BR112OTHERTXBCBS
2M1300OTHERTXMEDICAL LICENSE
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1679572499
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JONATHAN SCOTT QUINBY MD
Provider Business Mailing Address
First Line : 2 LONDON CT
Second Line :
City : HEATH
State : TX
Zip : 75032-6865
Country : US
Telephone Number : 469-243-9390
Fax Number :
Provider Business Practice Location Address
First Line : 17051 DALLAS PKWY STE 400
Second Line :
City : ADDISON
State : TX
Zip : 75001-7108
Country : US
Telephone Number : 469-243-9390
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 05/18/2020

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