Provider Demographics
NPI:1417927476
Name:ALBERTS, JEFFREY SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:SCOTT
Last Name:ALBERTS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 11647
Mailing Address - Street 2:
Mailing Address - City:DAYTONA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32120-1647
Mailing Address - Country:US
Mailing Address - Phone:386-274-7800
Mailing Address - Fax:386-274-7801
Practice Address - Street 1:459 LOCUST AVE
Practice Address - Street 2:MB #26
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-4808
Practice Address - Country:US
Practice Address - Phone:434-982-7150
Practice Address - Fax:434-982-7147
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101043793V207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA010039103OtherMEDICARE PIN
VA165677OtherANTHEM SVCS/HEALTHKEEPERS
VA46678OtherCOMMUNITY HEALTH
VAP00191931OtherMEDICARE PIN
VA8348103OtherCIGNA
VA010134111Medicaid
VA168202OtherSOUTHERN HEALTH
VA2129517OtherMAMSI
E38539Medicare UPIN
VA010000570Medicare PIN
VA8348103OtherCIGNA