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Individual

S SCOTT OLEXY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
1636 REGULUS AVE, VIRGINIA BEACH, VA 23461-2200
(757) 893-2015
Mailing address
1636 REGULUS AVE, VIRGINIA BEACH, VA 23461-2200
(757) 893-2015

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA9103313
FL
363AS0400X
Surgical Physician Assistant
Primary
0110002649
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
292202900
FL
Enumeration date
02/02/2006
Last updated
03/11/2009
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