MEDICARE: ALAN SCOTT KRIMSLEY M.D.,

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
1	2085R0001X	Radiation Oncology Physician	ME0042865	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	56169	OTHER	FL	BCBS

General Provider Information

NPI Number	:	1063403558
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALAN SCOTT KRIMSLEY M.D.,

Provider Business Mailing Address
First Line	:	4400 COUNTRY CLUB DR
Second Line	:
City	:	DICKINSON
State	:	TX
Zip	:	77539-7620
Country	:	US
Telephone Number	:	281-337-3423
Fax Number	:	281-337-2611

Provider Business Practice Location Address
First Line	:	604 W MIDWAY RD
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34982-4201
Country	:	US
Telephone Number	:	772-468-3222
Fax Number	:	772-460-7927

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/02/2005
Last Update Date	:	07/08/2007

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