Healthcare Provider Details

I. General information

NPI: 1326071184
Provider Name (Legal Business Name): JAMES DAVID SCOTT D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 06/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

176 MEDICAL CENTER DR
RAINELLE WV
25962-1064
US

IV. Provider business mailing address

176 MEDICAL CENTER DR
RAINELLE WV
25962-1064
US

V. Phone/Fax

Practice location:
  • Phone: 304-438-6188
  • Fax: 304-438-6819
Mailing address:
  • Phone: 304-438-6188
  • Fax: 304-438-6819

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number102050207
License Number StateVA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number1725
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: