Provider Demographics
NPI:1518950690
Name:SCHEETS, PHILIP J JR (DC)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:J
Last Name:SCHEETS
Suffix:JR
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9191 R G SKINNER PKWY UNIT 901
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256-9663
Mailing Address - Country:US
Mailing Address - Phone:904-454-4937
Mailing Address - Fax:
Practice Address - Street 1:9191 R G SKINNER PKWY UNIT 901
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-9663
Practice Address - Country:US
Practice Address - Phone:904-454-4937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-24
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC05549111N00000X
FLCH12398111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ9034609Medicaid
036393Medicare ID - Type Unspecified
NJ9034609Medicaid