=====================================================
General NPI Number Information
=====================================================
NPI Number | 1679785331
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SCOTT THOMAS FECHTER D.C.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 05/04/2007
-----------------------------------------------------
Last Update Date | 01/30/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 727 SAINT JOHNS AVE
-----------------------------------------------------
City | PALATKA
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32177-4645
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 386-328-4043
-----------------------------------------------------
Fax | 904-823-9394
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2550 US 1 S
-----------------------------------------------------
City | ST AUGUSTINE
-----------------------------------------------------
State | FL
-----------------------------------------------------
Zip | 32086-6194
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 904-823-8833
-----------------------------------------------------
Fax | 904-823-9394
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 111N00000X
-----------------------------------------------------
Taxonomy Name | Chiropractor
-----------------------------------------------------
License Number | CH8582
-----------------------------------------------------
License Number State | FL
-----------------------------------------------------