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General NPI Number Information
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NPI Number | 1528069267
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Entity Type | Individual
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Provider Name | DR. RANDALL A. SCOTT
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Gender | Male
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Dates
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Enumeration Date | 08/03/2005
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Last Update Date | 03/12/2008
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Provider Practice Location Address
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Address Line | 3300 RIVERMONT AVE
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City | LYNCHBURG
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State | VA
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Zip | 24503-2030
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Country | US
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Telephone | 434-200-5999
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Fax |
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Provider Business Mailing Address
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Address Line | 1204 FENWICK DR
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City | LYNCHBURG
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State | VA
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Zip | 24502-2112
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Country | US
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Telephone |
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 0101043633
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License Number State | VA
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