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General NPI Number Information
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NPI Number | 1891895389
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Entity Type | Individual
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Provider Name | THOMAS SCRUTON PA-C
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Gender | Male
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Dates
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Enumeration Date | 09/24/2006
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Last Update Date | 07/26/2016
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Provider Practice Location Address
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Address Line | 551 KOKOPELLI BLVD
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City | FRUITA
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State | CO
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Zip | 81521-6305
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Country | US
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Telephone | 970-270-2259
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Fax |
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Provider Business Mailing Address
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Address Line | 300 W OTTLEY AVE SUITE 170
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City | FRUITA
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State | CO
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Zip | 81521-2118
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Country | US
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Telephone | 970-858-2111
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 2640
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License Number State | CO
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