Healthcare Provider Details

I. General information

NPI: 1740261494
Provider Name (Legal Business Name): GAU-SCOTT CLINIC INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 E GARRIOTT RD STE B
ENID OK
73701-6156
US

IV. Provider business mailing address

915 E GARRIOTT RD STE B
ENID OK
73701-6156
US

V. Phone/Fax

Practice location:
  • Phone: 580-233-5544
  • Fax: 580-233-7895
Mailing address:
  • Phone: 580-233-5544
  • Fax: 580-233-7895

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1905
License Number StateOK
# 2
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number1905
License Number StateOK

VIII. Authorized Official

Name: DR. MICHAEL B SCOTT
Title or Position: OWNER
Credential: DO
Phone: 580-233-5544