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NPI Code Detail

MEDICARE: MARK J SCOTT P.A.-C.

MEDICARE: MARK J SCOTT P.A.-C.
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
1207RH0003XHematology & Oncology PhysicianPA0004TN
2207RH0003XHematology & Oncology PhysicianPA174AR
3207RH0003XHematology & Oncology Physician06PA022MS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
21124028469OTHERARBCBS AR

General Provider Information

NPI Number : 1124028469
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK J SCOTT P.A.-C.
Provider Business Mailing Address
First Line : 7945 WOLF RIVER BLVD
Second Line : STE 300
City : GERMANTOWN
State : TN
Zip : 38138-1762
Country : US
Telephone Number : 901-684-2400
Fax Number : 901-722-0442
Provider Business Practice Location Address
First Line : 7945 WOLF RIVER BLVD
Second Line : STE 300
City : GERMANTOWN
State : TN
Zip : 38138-1762
Country : US
Telephone Number : 901-684-2400
Fax Number : 901-722-0442
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2005
Last Update Date : 10/06/2009

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Directions to “ MARK J SCOTT P.A.-C.” Practice Location

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