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NPI Code Detail

MEDICARE: DWIGHT WISECARVER SCOTT DO

MEDICARE: DWIGHT WISECARVER SCOTT DO
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1366382194
Entity Type Code : Individual
Provider Name (Legal Business Name) : DWIGHT WISECARVER SCOTT DO
Provider Business Mailing Address
First Line : 7884 SILVER LAKE LN APT 302
Second Line :
City : MEMPHIS
State : TN
Zip : 38119-4560
Country : US
Telephone Number : 901-233-7227
Fax Number :
Provider Business Practice Location Address
First Line : 7031 SW 62ND AVE
Second Line :
City : SOUTH MIAMI
State : FL
Zip : 33143-4701
Country : US
Telephone Number : 305-284-7500
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/31/2026
Last Update Date : 03/31/2026

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Directions to “ DWIGHT WISECARVER SCOTT DO” Practice Location

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