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NPI Code Detail

MEDICARE: JOHN GLENN SCOTT M.D., PH.D.

MEDICARE: JOHN GLENN SCOTT M.D., PH.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 PhysicianMA72009NJ
2207Q00000XFamily Medicine Physician042-0011945VT
3207Q00000XFamily Medicine Physician59062TX
4207Q00000XFamily Medicine PhysicianTM2020-1177NM

General Provider Information

NPI Number : 1992884456
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN GLENN SCOTT M.D., PH.D.
Provider Business Mailing Address
First Line : 22730 DIAMOND BAY DR
Second Line :
City : FRANKSTON
State : TX
Zip : 75763-4020
Country : US
Telephone Number : 732-512-7704
Fax Number :
Provider Business Practice Location Address
First Line : 2450 S TELSHOR BLVD
Second Line :
City : LAS CRUCES
State : NM
Zip : 88011-5076
Country : US
Telephone Number : 802-748-9501
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2006
Last Update Date : 05/07/2024

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