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General NPI Number Information
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NPI Number | 1497075352
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Entity Type | Individual
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Provider Name | GREGORY RAY SCHOTT PA-C
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Gender | Male
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Dates
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Enumeration Date | 06/02/2010
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Last Update Date | 06/02/2010
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Provider Practice Location Address
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Address Line | 836 PRUDENTIAL DRIVE STE 1601
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City | JACKSONVILLE
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State | FL
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Zip | 32007
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Country | US
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Telephone | 904-396-2400
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Fax |
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Provider Business Mailing Address
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Address Line | 575 PINE FOREST DRIVE, N.
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City | ORANGE PARK
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State | FL
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Zip | 32003
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Country | US
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Telephone | 904-514-1687
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Fax | 904-215-8299
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1650FLORIDA
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License Number State | FL
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