MEDICARE: DR. JOYCE ELAINE SCOTT D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207QG0300X	Geriatric Medicine (Family Medicine) Physician	DO 1091	TN
2	207Q00000X	Family Medicine Physician	DO1091	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	3091574	OTHER	TN	BCBSTN

General Provider Information

NPI Number	:	1063429546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOYCE ELAINE SCOTT D.O.

Provider Business Mailing Address
First Line	:	1456 PROCTOR CREEK RD
Second Line	:
City	:	CELINA
State	:	TN
Zip	:	38551-6144
Country	:	US
Telephone Number	:	931-243-4312
Fax Number	:	931-243-4311

Provider Business Practice Location Address
First Line	:	1456 PROCTOR CREEK RD
Second Line	:
City	:	CELINA
State	:	TN
Zip	:	38551-6144
Country	:	US
Telephone Number	:	931-243-4312
Fax Number	:	931-243-4311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	12/23/2009

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