Healthcare Provider Details

I. General information

NPI: 1386645471
Provider Name (Legal Business Name): JEFFREY ALLEN SCOTT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2005
Last Update Date: 09/18/2025
Certification Date: 09/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 QUIK TRIP WAY
BELTON MO
64012-4658
US

IV. Provider business mailing address

820 QUIK TRIP WAY
BELTON MO
64012-4658
US

V. Phone/Fax

Practice location:
  • Phone: 816-425-3703
  • Fax: 888-498-3417
Mailing address:
  • Phone: 816-425-3703
  • Fax: 888-498-3417

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number36345
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: