Healthcare Provider Details

I. General information

NPI: 1356262448
Provider Name (Legal Business Name): DAVION SCOTT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/23/2026
Last Update Date: 07/23/2026
Certification Date: 07/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1822 N 29TH ST
LINCOLN NE
68503-1215
US

IV. Provider business mailing address

3231 N 68TH ST
LINCOLN NE
68507-2621
US

V. Phone/Fax

Practice location:
  • Phone: 402-432-1685
  • Fax:
Mailing address:
  • Phone: 402-432-1685
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171W00000X
TaxonomyContractor
License Number
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: