Healthcare Provider Details

I. General information

NPI: 1750555488
Provider Name (Legal Business Name): J. SCOTT TRAYER D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2008
Last Update Date: 06/07/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

131 E MCKINLEY ST
CHAMBERSBURG PA
17201-3522
US

IV. Provider business mailing address

131 E MCKINLEY ST
CHAMBERSBURG PA
17201-3522
US

V. Phone/Fax

Practice location:
  • Phone: 717-267-1515
  • Fax: 717-267-2316
Mailing address:
  • Phone: 717-267-1515
  • Fax: 717-267-2316

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberOS008691L
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier0017543810004
Identifier TypeMEDICAID
Identifier StatePA
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: