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General NPI Number Information
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NPI Number | 1972688836
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Entity Type | Individual
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Provider Name | SCOTT PATRICK MARKHAM D.O.
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Gender | Male
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 09/29/2020
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Provider Practice Location Address
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Address Line | 1680 WILLOW CREEK RD
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City | PRESCOTT
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State | AZ
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Zip | 86301-1108
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Country | US
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Telephone | 928-778-3950
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Fax | 928-778-3999
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Provider Business Mailing Address
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Address Line | 3192 WILLOW CREEK RD
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City | PRESCOTT
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State | AZ
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Zip | 86301-6610
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Country | US
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Telephone | 928-445-1234
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Fax | 928-778-3999
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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 | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 4498
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License Number State | AZ
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