MEDICARE: CYNTHIA JEAN SCOTT M.D.

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	207VG0400X	Gynecology Physician	14792	LA

General Provider Information

NPI Number	:	1275514804
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CYNTHIA JEAN SCOTT M.D.

Provider Business Mailing Address
First Line	:	4150 NELSON RD
Second Line	:	STE B-7
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-4148
Country	:	US
Telephone Number	:	337-474-3307
Fax Number	:	337-474-3308

Provider Business Practice Location Address
First Line	:	4150 NELSON RD
Second Line	:	STE B-7
City	:	LAKE CHARLES
State	:	LA
Zip	:	70605-4148
Country	:	US
Telephone Number	:	337-474-3307
Fax Number	:	337-474-3308

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	07/08/2007

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