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Individual

SCOTT T FAUTH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4131 UNIVERSITY BLVD S, #16, JACKSONVILLE, FL 32216-4326
(904) 733-7408
(904) 733-7668
Mailing address
4131 UNIVERSITY BLVD S, #16, JACKSONVILLE, FL 32216-4326
(904) 733-7408
(904) 733-7668

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
ME0038362
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
15657
BCBS OF FL
FL
Enumeration date
09/26/2005
Last updated
07/08/2007
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