Healthcare Provider Details

I. General information

NPI: 1689934101
Provider Name (Legal Business Name): SCOTT D. MCLAFFERTY DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/17/2012
Last Update Date: 09/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

471 E BROAD ST STE 1400
COLUMBUS OH
43215-3806
US

IV. Provider business mailing address

471 E BROAD ST STE 1400
COLUMBUS OH
43215-3806
US

V. Phone/Fax

Practice location:
  • Phone: 614-228-7231
  • Fax:
Mailing address:
  • Phone: 614-228-7231
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number34.013437
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number34.013437
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: