Healthcare Provider Details

I. General information

NPI: 1205646296
Provider Name (Legal Business Name): JAY WESTON SCOTT PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/10/2025
Last Update Date: 04/03/2025
Certification Date: 04/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

448 STATE HIGHWAY 248
BRANSON MO
65616-3725
US

IV. Provider business mailing address

448 STATE HIGHWAY 248 STE 140
BRANSON MO
65616-3725
US

V. Phone/Fax

Practice location:
  • Phone: 620-794-1139
  • Fax:
Mailing address:
  • Phone: 417-337-9808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: