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General NPI Number Information
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NPI Number | 1558928713
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Entity Type | Organization
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Legal Business Name | KIM P SCOTT MD, LLC
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Dates
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Enumeration Date | 05/23/2019
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Last Update Date | 05/23/2019
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Provider Practice Location Address
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Address Line | 1041 N HIGHLAND AVE
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City | MURFREESBORO
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State | TN
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Zip | 37130-2450
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Country | US
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Telephone | 615-617-3499
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Fax | 615-617-3627
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Provider Business Mailing Address
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Address Line | 5833 AEDC RD
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City | ESTILL SPRINGS
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State | TN
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Zip | 37330-3915
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Country | US
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Telephone | 931-392-4169
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Fax | 931-392-4187
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Authorized Official
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Title or Position | OWNER
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Name | KIM PUCKETT SCOTT
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Credential | MD
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Telephone | 615-617-3499
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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