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General NPI Number Information
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NPI Number | 1063237121
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Entity Type | Organization
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Legal Business Name | SCOTT II MEDICAL CLINIC
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Dates
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Enumeration Date | 11/22/2024
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Last Update Date | 11/22/2024
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Provider Practice Location Address
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Address Line | 4839 SOUTH DARROW DRIVE G258
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City | TAMPA
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State | AZ
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Zip | 85282-6661
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Country | US
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Telephone | 480-203-6728
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Fax |
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Provider Business Mailing Address
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Address Line | 4839 SOUTH DARROW DRIVE G258
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City | TAMPA
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State | AZ
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Zip | 85282-6661
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Country | US
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Telephone | 480-203-6728
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Fax |
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Authorized Official
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Title or Position | ANESTHESIOLOGIST/ATTORNEY/OWNER
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Name | DR. GENE EDWARD SCOTT II
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Credential | M.D., D.O.
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Telephone | 480-208-6728
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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