Healthcare Provider Details

I. General information

NPI: 1346280047
Provider Name (Legal Business Name): JAMES R SCOTT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 04/23/2025
Certification Date: 04/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

631 N 8TH ST
MISSOURI VALLEY IA
51555-1102
US

IV. Provider business mailing address

631 N 8TH ST
MISSOURI VALLEY IA
51555-1102
US

V. Phone/Fax

Practice location:
  • Phone: 712-642-2784
  • Fax: 712-642-9259
Mailing address:
  • Phone: 712-642-2784
  • Fax: 712-642-9259

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number320
License Number StateNE
# 2
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberDO-04157
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: