Provider Demographics
NPI:1801682489
Name:HALFHILL, SCOTT DYLAN (IDC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:DYLAN
Last Name:HALFHILL
Suffix:
Gender:
Credentials:IDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3295 WAINRIGHT LN
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2053
Mailing Address - Country:US
Mailing Address - Phone:228-313-0460
Mailing Address - Fax:
Practice Address - Street 1:USS KIDD (DDG 100)
Practice Address - Street 2:
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96670
Practice Address - Country:US
Practice Address - Phone:228-313-0460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-18
Last Update Date:2025-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman