| Donald B. Schak Sr., M.d., Pa | |
|
120 S John Sims Pkwy Suite C Valparaiso FL 32580-1212 | |
| (850) 678-0061 | |
| (850) 678-0068 |
| Full Name | Donald B. Schak Sr., M.d., Pa |
|---|---|
| Speciality | Family Medicine |
| Location | 120 S John Sims Pkwy, Valparaiso, Florida |
| Authorized Official Name and Position | Donald B. Schak (DIRECT OWNER) |
| Authorized Official Contact | 8506780061 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Donald B. Schak Sr., M.d., Pa 120 S John Sims Pkwy Suite C Valparaiso FL 32580-1212 Ph: (850) 678-0061 | Donald B. Schak Sr., M.d., Pa 120 S John Sims Pkwy Suite C Valparaiso FL 32580-1212 Ph: (850) 678-0061 |
| NPI Number | 1629092069 |
|---|---|
| Provider Enumeration Date | 07/27/2006 |
| Last Update Date | 03/13/2013 |
| Medicare PECOS PAC ID | 3476708280 |
|---|---|
| Medicare Enrollment ID | O20130228000292 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629092069 | NPI | - | NPPES |
| 256492100 | Medicaid | FL | |
| 44534 | Other | FL | BCBS |
| B288 | Other | FL | HEALTH OPTIONS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | ME76306 (Florida) | Primary |
| Provider Name | Donald B Schak |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1306850284 PECOS PAC ID: 3870560543 Enrollment ID: I20040913000674 |
Emerald Coast Family Medicine Inc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 143 S John Sims Pkwy, Valparaiso, FL 32580 Phone: 850-729-3300 Fax: 850-729-3100 | |
Wyndal K Blankenship Md Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 120 S John Sims Pkwy, Valparaiso, FL 32580 Phone: 850-678-6621 Fax: 850-729-0331 |