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NPI Code Detail

MEDICARE: JOHN SCOTT PA

MEDICARE: JOHN SCOTT PA
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
1363AM0700XMedical Physician Assistant0110840842VA
2363AM0700XMedical Physician AssistantPA30149DC
3207Q00000XFamily Medicine PhysicianPA2016-0036NM

General Provider Information

NPI Number : 1225127343
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN SCOTT PA
Provider Business Mailing Address
First Line : PO BOX 158
Second Line :
City : ESPANOLA
State : NM
Zip : 87532-0158
Country : US
Telephone Number : 505-753-7218
Fax Number : 505-747-7396
Provider Business Practice Location Address
First Line : 1235 8TH ST
Second Line :
City : LAS VEGAS
State : NM
Zip : 87701-4219
Country : US
Telephone Number : 505-425-6788
Fax Number : 505-425-5408
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/12/2006
Last Update Date : 07/21/2022

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Directions to “ JOHN SCOTT PA” Practice Location

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