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NPI Code Detail

MEDICARE: DR. SCOTT W GROVER D.O.

MEDICARE:  DR. SCOTT W GROVER  D.O.
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
1208600000XSurgery PhysicianO-220ID
2208600000XSurgery Physician5215595-1204UT

General Provider Information

NPI Number : 1609860600
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT W GROVER D.O.
Provider Business Mailing Address
First Line : 2380 N 400 E STE E
Second Line :
City : NORTH LOGAN
State : UT
Zip : 84341-1767
Country : US
Telephone Number : 435-752-7122
Fax Number : 435-755-9579
Provider Business Practice Location Address
First Line : 2380 N 400 E STE E
Second Line :
City : NORTH LOGAN
State : UT
Zip : 84341-1767
Country : US
Telephone Number : 435-752-7122
Fax Number : 435-755-9579
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/06/2005
Last Update Date : 07/29/2024

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Directions to “ DR. SCOTT W GROVER D.O.” Practice Location

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