Provider Demographics
NPI:1962664086
Name:SCALES, JOHN SOCRATES (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:SOCRATES
Last Name:SCALES
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 1:1490 SE MAGNOLIA EXT
Mailing Address - Street 2:
Mailing Address - City:OCALA
Mailing Address - State:FL
Mailing Address - Zip Code:34471-4443
Mailing Address - Country:US
Mailing Address - Phone:352-671-4221
Mailing Address - Fax:352-671-4393
Practice Address - Street 1:1490 SE MAGNOLIA EXT
Practice Address - Street 2:
Practice Address - City:OCALA
Practice Address - State:FL
Practice Address - Zip Code:34471-4443
Practice Address - Country:US
Practice Address - Phone:352-671-4300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME 1160002085R0202X, 2085R0204X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0204XAllopathic & Osteopathic PhysiciansRadiologyVascular & Interventional Radiology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
1962664086OtherNPI
FL009840200Medicaid