Healthcare Provider Details

I. General information

NPI: 1578908935
Provider Name (Legal Business Name): JOHN RC SCOTT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/29/2013
Last Update Date: 02/21/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 RIO VISTA DR
FALLON NV
89406-5463
US

IV. Provider business mailing address

1001 RIO VISTA DR
FALLON NV
89406-5463
US

V. Phone/Fax

Practice location:
  • Phone: 775-423-3634
  • Fax: 775-423-5694
Mailing address:
  • Phone: 775-423-3634
  • Fax: 775-423-5694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6932
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: