Provider Demographics
NPI:1144212267
Name:KLIMP, SCOTT A (PA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:KLIMP
Suffix:
Gender:M
Credentials:PA
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Mailing Address - Street 1:8525 WHIRLAWAY DR
Mailing Address - Street 2:
Mailing Address - City:MIDLOTHIAN
Mailing Address - State:VA
Mailing Address - Zip Code:23112-1960
Mailing Address - Country:US
Mailing Address - Phone:804-608-1791
Mailing Address - Fax:804-608-1791
Practice Address - Street 1:700 24TH ST
Practice Address - Street 2:
Practice Address - City:FORT LEE
Practice Address - State:VA
Practice Address - Zip Code:23801-1716
Practice Address - Country:US
Practice Address - Phone:804-734-9295
Practice Address - Fax:804-734-9016
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI5601003305363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
Q18307Medicare UPIN