MEDICARE: DONALD S. SCOTT, PH.D., INC.

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	103T00000X	Psychologist

General Provider Information

NPI Number	:	1235260886
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DONALD S. SCOTT, PH.D., INC.

Provider Business Mailing Address
First Line	:	5335 FAR HILLS AVE STE 221
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45429-2380
Country	:	US
Telephone Number	:	937-438-7580
Fax Number	:	937-438-3351

Provider Business Practice Location Address
First Line	:	5335 FAR HILLS AVE STE 221
Second Line	:
City	:	DAYTON
State	:	OH
Zip	:	45429-2380
Country	:	US
Telephone Number	:	937-438-7580
Fax Number	:	937-438-3351

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DONALD STUART SCOTT
Credential	:	PH.D.
Telephone Number	:	937-438-7580

Provider Enumeration Date	:	03/07/2007
Last Update Date	:	04/14/2017

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