DR. SCOTT WAMBOLT D.O. NPI 1427582881

NPI Information

NPI: 1427582881
Provider Name: DR. SCOTT WAMBOLT, D.O.
Classification: General Practice - 208D00000X
Entity Type: Individual
Organization: MATSU EMERGENCY MEDICINE PHYSICIANS CORP

PECOS Registration: Yes

Address:
2200 BERGQUIST DR STE 1
WHMC/GE-2200
JBSA LACKLAND AFB, TX
ZIP 78236
Phone: (774) 249-9643
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DR. Scott Wambolt, D.O. is a general practice in Jbsa Lackland Afb, TX with 7 years of experience. DR. Scott Wambolt, D.O. NPI is 1427582881. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2200 BERGQUIST DR STE 1
WHMC/GE-2200
JBSA LACKLAND AFB, TX
ZIP 78236-300
Phone: (774) 249-9643

The NPI 1427582881 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/12/2017 and was last updated on 12/31/2018.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	390200000X	Student in an Organized Health Care Education/Training Program			TEXAS	No
2	208D00000X	General Practice		0102205459	VIRGINIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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