Provider Demographics
NPI:1508966532
Name:SCC GROUP INC
Entity Type:Organization
Organization Name:SCC GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:K
Authorized Official - Last Name:MULKEY
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:863-202-0335
Mailing Address - Street 1:1308 TALBOTT CIR
Mailing Address - Street 2:
Mailing Address - City:AVON PARK
Mailing Address - State:FL
Mailing Address - Zip Code:33825-9721
Mailing Address - Country:US
Mailing Address - Phone:863-202-0335
Mailing Address - Fax:863-583-4177
Practice Address - Street 1:1308 TALBOTT CIR
Practice Address - Street 2:
Practice Address - City:AVON PARK
Practice Address - State:FL
Practice Address - Zip Code:33825-9721
Practice Address - Country:US
Practice Address - Phone:863-202-0335
Practice Address - Fax:863-452-0930
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL643642-0002691111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL99998OtherBCBSFL
FLK0588Medicare ID - Type Unspecified
FL99998OtherBCBSFL