Healthcare Provider Details

I. General information

NPI: 1972185544
Provider Name (Legal Business Name): AMANDA KAYLA SCOTT DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/23/2021
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 ARCH ST STE 3A
AKRON OH
44304-1447
US

IV. Provider business mailing address

55 ARCH ST STE 3A
AKRON OH
44304-1447
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3584
  • Fax: 234-312-2307
Mailing address:
  • Phone: 330-375-3584
  • Fax: 234-312-2307

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number34.016823
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: