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General NPI Number Information
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NPI Number | 1841269982
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Entity Type | Individual
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Provider Name | SCOT R MCKENNA M.D., P.C.
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Gender | Male
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Dates
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Enumeration Date | 03/14/2006
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 631 NORTHERN BLVD
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City | SOUTH ABINGTON TOWNSHIP
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State | PA
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Zip | 18411-9025
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Country | US
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Telephone | 570-340-6920
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Fax | 570-340-6923
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Provider Business Mailing Address
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Address Line | 631 NORTHERN BLVD FL 2
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City | SOUTH ABINGTON TOWNSHIP
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State | PA
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Zip | 18411-9025
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Country | US
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Telephone | 570-340-6920
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Fax | 570-340-6923
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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 | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | MD054788-L
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License Number State | PA
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