Provider Demographics
NPI:1306815659
Name:GROUNDS, DAVID SCOTT (DO)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:SCOTT
Last Name:GROUNDS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1119 BAYSHORE DR
Mailing Address - Street 2:
Mailing Address - City:NICEVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32578-3034
Mailing Address - Country:US
Mailing Address - Phone:850-729-3977
Mailing Address - Fax:
Practice Address - Street 1:96TH MDSS/SGSO
Practice Address - Street 2:307 BOATNER RD, SUITE 114
Practice Address - City:EGLIN AFB
Practice Address - State:FL
Practice Address - Zip Code:32542
Practice Address - Country:US
Practice Address - Phone:850-883-8227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN02002784A207P00000X
FLOS9853207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine