Provider Demographics
NPI:1659349371
Name:SCHOLES, JOHN VACKINER (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:VACKINER
Last Name:SCHOLES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:114 WOODLAND STREET
Mailing Address - Street 2:ST FRANCIS HOSPITAL DEPARTMENT OF PATHOLOGY
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06105
Mailing Address - Country:US
Mailing Address - Phone:860-714-4280
Mailing Address - Fax:860-714-8021
Practice Address - Street 1:114 WOODLAND STREET
Practice Address - Street 2:ST FRANCIS HOSPITAL DEPARTMENT OF PATHOLOGY
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06105
Practice Address - Country:US
Practice Address - Phone:860-714-4280
Practice Address - Fax:860-714-8021
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2015-03-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT021192207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTF20981Medicaid
CTF20981Medicaid
F20981Medicare UPIN