Healthcare Provider Details

I. General information

NPI: 1619998168
Provider Name (Legal Business Name): JEFFREY DOUGLAS SCOTT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/21/2006
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3417 N 32ND ST
PHOENIX AZ
85018-5606
US

IV. Provider business mailing address

3417 N 32ND ST
PHOENIX AZ
85018-5606
US

V. Phone/Fax

Practice location:
  • Phone: 602-368-3600
  • Fax: 602-368-3235
Mailing address:
  • Phone: 602-368-3600
  • Fax: 602-368-3235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number40645
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: