Healthcare Provider Details

I. General information

NPI: 1316949209
Provider Name (Legal Business Name): SCOTT A HANDLEY DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 03/14/2022
Certification Date: 03/14/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

694 MAIN ST
EAST GREENWICH RI
02818-3540
US

IV. Provider business mailing address

15 DEEP MEADOW LN
EAST GREENWICH RI
02818-2068
US

V. Phone/Fax

Practice location:
  • Phone: 401-884-2821
  • Fax:
Mailing address:
  • Phone: 941-730-3261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberDPM00353
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: