# SCOTTSBURG EMERGENCY SERVICES, LLC

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396703062
- **Authorized official:** EUGENE DAUCHERT (CEO/PRESIDENT)
- **Authorized official phone:** (919) 768-4392

## Contact information

- **Practice address:** 1451 N GARDNER ST, SCOTTSBURG, IN 47170-7751
- **Practice address phone:** (812) 752-3456
- **Mailing address:** PO BOX 827429, PHILADELPHIA, PA 19182-7429
- **Mailing address phone:** (904) 805-1300
- **Mailing address fax:** (904) 805-1302

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207P00000X | Emergency Medicine Physician | — | NULL | — |
| 207P00000X | Emergency Medicine Physician | — | — | — |
| 363A00000X | Physician Assistant | — | NULL | — |
| 363A00000X | Physician Assistant | — | — | — |
| 363L00000X | Nurse Practitioner | — | NULL | Yes |
| 363L00000X | Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/03/2006
- **Last updated:** 09/11/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 000000201878 | BLUE CROSS & BLUE SHIELD | IN |
| 01 | — | 1172648 | PASSPORT HEALTH PLAN | IN |
| 01 | — | 65934358 | KY MEDICAID | IN |
| 01 | — | DD6466 | RAIL ROAD MEDICARE | IN |