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NPI Code Detail

MEDICARE: SCOTT E. PREUSEN M.D.

MEDICARE: SCOTT E. PREUSEN 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
12085R0202XDiagnostic Radiology PhysicianME157062FL
22085R0202XDiagnostic Radiology Physician036107496IL

General Provider Information

NPI Number : 1437151826
Entity Type Code : Individual
Provider Name (Legal Business Name) : SCOTT E. PREUSEN M.D.
Provider Business Mailing Address
First Line : PO BOX 19248
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62794-9248
Country : US
Telephone Number : 217-528-7541
Fax Number :
Provider Business Practice Location Address
First Line : 1025 S 6TH ST
Second Line :
City : SPRINGFIELD
State : IL
Zip : 62703-2499
Country : US
Telephone Number : 217-528-7541
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2005
Last Update Date : 08/20/2023

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