Healthcare Provider Details

I. General information

NPI: 1801877808
Provider Name (Legal Business Name): JAMES L SCOTT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/08/2005
Last Update Date: 04/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 CIRCULAR AVE
HAMDEN CT
06514-4004
US

IV. Provider business mailing address

95 CIRCULAR AVE
HAMDEN CT
06514-4004
US

V. Phone/Fax

Practice location:
  • Phone: 203-288-6253
  • Fax: 203-288-0948
Mailing address:
  • Phone: 203-288-6253
  • Fax: 203-288-0948

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number022953
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: