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General NPI Number Information
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NPI Number | 1609719913
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Entity Type | Individual
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Provider Name | RICHARD BERNARD SCOTT JR.
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Gender | Male
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Dates
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Enumeration Date | 04/11/2026
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Last Update Date | 04/11/2026
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Provider Practice Location Address
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Address Line | 131 WERTZ AVE NW
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City | CANTON
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State | OH
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Zip | 44708-4171
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Country | US
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Telephone | 330-714-7035
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Fax |
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Provider Business Mailing Address
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Address Line | 393 SLATE RIDGE DR
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City | BARBERTON
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State | OH
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Zip | 44203-8608
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Country | US
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Telephone | 330-714-7035
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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 | 172V00000X
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Taxonomy Name | Community Health Worker
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License Number | PRS.007590
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License Number State | OH
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