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General NPI Number Information
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NPI Number | 1275517245
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Entity Type | Individual
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Provider Name | JORDAN E. SCOTT M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/02/2005
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Last Update Date | 05/04/2015
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Provider Practice Location Address
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Address Line | 79 ERDMAN WAY SUITE 101
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City | LEOMINSTER
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State | MA
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Zip | 01453
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Country | US
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Telephone | 978-537-4805
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Fax | 978-537-2185
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Provider Business Mailing Address
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Address Line | 79 ERDMAN WAY SUITE 101
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City | LEOMINSTER
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State | MA
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Zip | 01453
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Country | US
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Telephone | 978-537-4805
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Fax | 978-537-2185
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 214922
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License Number State | MA
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