MEDICARE: HEATH ELLIOTT SCOTT MD

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	207Q00000X	Family Medicine Physician	18042	MS

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

General Provider Information

NPI Number	:	1205881489
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HEATH ELLIOTT SCOTT MD

Provider Business Mailing Address
First Line	:	PO BOX 1509
Second Line	:
City	:	YAZOO CITY
State	:	MS
Zip	:	39194-1509
Country	:	US
Telephone Number	:	662-746-6083
Fax Number	:	662-746-1954

Provider Business Practice Location Address
First Line	:	805 E FIFTEENTH ST
Second Line	:
City	:	YAZOO CITY
State	:	MS
Zip	:	39194-7607
Country	:	US
Telephone Number	:	662-746-6083
Fax Number	:	662-746-1954

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

Provider Enumeration Date	:	05/24/2006
Last Update Date	:	03/13/2008

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Directions to “ HEATH ELLIOTT SCOTT MD” Practice Location

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