Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. BRADLEY SCOTT BOUTCHER, PA-C
ActiveMR. BRADLEY SCOTT BOUTCHER, PA-C is a Physician Assistant healthcare provider located in JACKSONVILLE, Florida. NPI 1730840729 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · JACKSONVILLE, FL
Registration Details
- NPI Number
- 1730840729
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Jan 3, 2022 (4.5854222868886 yrs)
- Last Updated
- Mar 31, 2025
- License
-
9115278 (FL)
Practice Information
- Address
-
836 PRUDENTIAL DRIVESTE 1804JACKSONVILLE, FL, 322078345Browse FL providers · Browse ZIP 32207
- Phone
- 9043983888
- Fax
- 9044006675
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in JACKSONVILLE, FL
| Name | Credential | NPI |
|---|---|---|
| MR. JASON KOTULA | P.A. | 1548263882 |
| DANIEL A BECK | PA-C | 1780688465 |
| JOHN MICHAEL TIERNEY | PA | 1124023445 |
| KAREN ELAINE MAYES | PA | 1437154887 |
| EDWIN HAUSER | PA | 1760487185 |
| PETER J RIGGS | PA | 1255336574 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.