Healthcare Provider Details

I. General information

NPI: 1891722716
Provider Name (Legal Business Name): SCOTT P BARTLETT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2006
Last Update Date: 01/17/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34TH & CIVIC CENTER BLVD CHILDREN'S SURGICAL ASSOCIATES, LTD
PHILADELPHIA PA
19104-4206
US

IV. Provider business mailing address

100 EAST PENN SQUARE THE WANAMAKER BLDG. 9TH FL
PHILADELPHIA PA
19107-3323
US

V. Phone/Fax

Practice location:
  • Phone: 215-590-2208
  • Fax: 215-590-2496
Mailing address:
  • Phone: 267-425-9538
  • Fax: 267-425-9552

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberMD033152E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: