Healthcare Provider Details

I. General information

NPI: 1760796122
Provider Name (Legal Business Name): SCOTT LANFORD AUD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2010
Last Update Date: 07/22/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2440 M ST NW SUITE 606
WASHINGTON DC
20037-1404
US

IV. Provider business mailing address

2440 M ST NW SUITE 606
WASHINGTON DC
20037-1404
US

V. Phone/Fax

Practice location:
  • Phone: 202-785-8300
  • Fax: 202-785-5040
Mailing address:
  • Phone: 202-785-8300
  • Fax: 202-785-5040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number1196
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: