Healthcare Provider Details

I. General information

NPI: 1063429546
Provider Name (Legal Business Name): JOYCE ELAINE SCOTT D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2006
Last Update Date: 12/23/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1456 PROCTOR CREEK RD
CELINA TN
38551-6144
US

IV. Provider business mailing address

1456 PROCTOR CREEK RD
CELINA TN
38551-6144
US

V. Phone/Fax

Practice location:
  • Phone: 931-243-4312
  • Fax: 931-243-4311
Mailing address:
  • Phone: 931-243-4312
  • Fax: 931-243-4311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QG0300X
TaxonomyGeriatric Medicine (Family Medicine) Physician
License NumberDO 1091
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO1091
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: