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NPI Code Detail

MEDICARE: DR. SCOTT E TROUT D.D.S.

MEDICARE: DR. SCOTT E TROUT D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11223G0001XGeneral Practice Dentistry12008524AIN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1184790578
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT E TROUT D.D.S.
Provider Business Mailing Address
First Line : 4017 W JACKSON ST
Second Line :
City : MUNCIE
State : IN
Zip : 47304-3610
Country : US
Telephone Number : 765-747-7992
Fax Number : 765-288-5542
Provider Business Practice Location Address
First Line : 4017 W JACKSON ST
Second Line :
City : MUNCIE
State : IN
Zip : 47304-3610
Country : US
Telephone Number : 765-747-7992
Fax Number : 765-288-5542
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/28/2006
Last Update Date : 05/22/2008

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