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NPI Code Detail

MEDICARE: STEVEN N SCOTT M.D.

MEDICARE: STEVEN N SCOTT M.D.
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
1207Q00000XFamily Medicine PhysicianIL

General Provider Information

NPI Number : 1326045832
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEVEN N SCOTT M.D.
Provider Business Mailing Address
First Line : 209 NW 11TH ST
Second Line :
City : FAIRFIELD
State : IL
Zip : 62837-1218
Country : US
Telephone Number : 618-842-4470
Fax Number : 618-842-3437
Provider Business Practice Location Address
First Line : 209 NW 11TH ST
Second Line :
City : FAIRFIELD
State : IL
Zip : 62837-1218
Country : US
Telephone Number : 618-842-4470
Fax Number : 618-842-3437
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2005
Last Update Date : 07/08/2007

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