Healthcare Provider Details

I. General information

NPI: 1174051718
Provider Name (Legal Business Name): SCOTT INNES MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/26/2017
Last Update Date: 09/19/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 HOSPITAL PL STE 204
SOLDOTNA AK
99669-7559
US

IV. Provider business mailing address

240 HOSPITAL PL STE 204
SOLDOTNA AK
99669-7559
US

V. Phone/Fax

Practice location:
  • Phone: 907-252-8063
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DAVID SCOTT INNES
Title or Position: OWNER
Credential: MD
Phone: 907-262-1080