Basic Information
| Provider Information | |||||||||
| NPI: | 1780698779 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOBEE | ||||||||
| FirstName: | JEREMY | ||||||||
| MiddleName: | JAMES | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2700 STANLEY GAULT PKWY | ||||||||
| Address2: | SUITE 129 | ||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402235132 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5029686979 | ||||||||
| FaxNumber: | 5029685444 | ||||||||
| Practice Location | |||||||||
| Address1: | 950 BRECKENRIDGE LN STE 200 | ||||||||
| Address2: | |||||||||
| City: | LOUISVILLE | ||||||||
| State: | KY | ||||||||
| PostalCode: | 402075929 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5028936777 | ||||||||
| FaxNumber: | 5028995535 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/28/2006 | ||||||||
| LastUpdateDate: | 12/02/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/02/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 34075 | KY | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 64030844 | 05 | KY | MEDICAID | 2623 | 01 | KY | BLUE CROSS | OTHER | 1141326 | 01 | KY | PASSPORT | OTHER |