Provider Demographics
NPI:1053564237
Name:DAMCOTT, JAMIE (ATC)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:DAMCOTT
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6402 MEADOW FIELD CIR
Mailing Address - Street 2:
Mailing Address - City:PENSACOLA
Mailing Address - State:FL
Mailing Address - Zip Code:32526-5103
Mailing Address - Country:US
Mailing Address - Phone:850-207-9878
Mailing Address - Fax:
Practice Address - Street 1:1941 INTERSTATE CIR
Practice Address - Street 2:
Practice Address - City:PENSACOLA
Practice Address - State:FL
Practice Address - Zip Code:32526-9259
Practice Address - Country:US
Practice Address - Phone:850-207-9878
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2020-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
396913246Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other