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NPI Code Detail

MEDICARE: MR. JEFFREY BRYAN SCOTT

MEDICARE:  MR. JEFFREY BRYAN SCOTT
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
1103K00000XBehavior Analyst

General Provider Information

NPI Number : 1629483037
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JEFFREY BRYAN SCOTT
Provider Business Mailing Address
First Line : 338 FALLING LN
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23454-3969
Country : US
Telephone Number : 757-201-8010
Fax Number :
Provider Business Practice Location Address
First Line : 338 FALLING LN
Second Line :
City : VIRGINIA BEACH
State : VA
Zip : 23454-3969
Country : US
Telephone Number : 757-201-8010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2014
Last Update Date : 06/24/2014

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Directions to “ MR. JEFFREY BRYAN SCOTT ” Practice Location

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