Healthcare Provider Details

I. General information

NPI: 1538131578
Provider Name (Legal Business Name): LARRY D SCORTT D.P.M.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/03/2006
Last Update Date: 06/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7210 N MILBURN AVE SUITE 101
FRESNO CA
93722-0022
US

IV. Provider business mailing address

7210 N MILBURN SUITE 101
FRESNO CA
93722-0022
US

V. Phone/Fax

Practice location:
  • Phone: 559-224-5101
  • Fax: 559-224-4396
Mailing address:
  • Phone: 559-224-5101
  • Fax: 559-224-4396

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberE2629
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: