MEDICARE: DR. SCOTT PRICE 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	207Q00000X	Family Medicine Physician	34174	AZ

General Provider Information

NPI Number	:	1437372943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT PRICE M.D.

Provider Business Mailing Address
First Line	:	2668 E DESERT LN
Second Line	:
City	:	GILBERT
State	:	AZ
Zip	:	85234-2816
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6030 S KENT
Second Line	:	BUILDING 558
City	:	MESA
State	:	AZ
Zip	:	85212-6004
Country	:	US
Telephone Number	:	480-988-6561
Fax Number	:	480-988-6560

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

Provider Enumeration Date	:	04/11/2007
Last Update Date	:	07/08/2007

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