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NPI Code Detail

MEDICARE: DIANE M SCOTT P.A.

MEDICARE:   DIANE M SCOTT  P.A.
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
1363A00000XPhysician Assistant2192AZ

Other Identifiers

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

General Provider Information

NPI Number : 1285694299
Entity Type Code : Individual
Provider Name (Legal Business Name) : DIANE M SCOTT P.A.
Provider Business Mailing Address
First Line : PO BOX 859
Second Line :
City : PAYSON
State : AZ
Zip : 85547-0859
Country : US
Telephone Number : 928-472-5260
Fax Number : 928-472-3444
Provider Business Practice Location Address
First Line : 126 E MAIN ST
Second Line : SUITE D
City : PAYSON
State : AZ
Zip : 85541-5488
Country : US
Telephone Number : 928-472-5260
Fax Number : 928-472-3444
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 12/31/2014

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Directions to “ DIANE M SCOTT P.A.” Practice Location

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