MEDICARE: LARRY SCORTT

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	213ES0103X	Foot & Ankle Surgery Podiatrist	E26290	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	480022521	OTHER	CA	RAILROAD MEDICARE

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	:	1477735801
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LARRY SCORTT

Provider Business Mailing Address
First Line	:	5066 N FRESNO ST STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-7615
Country	:	US
Telephone Number	:	559-206-5688
Fax Number	:	559-283-8440

Provider Business Practice Location Address
First Line	:	5066 N FRESNO ST STE 101
Second Line	:
City	:	FRESNO
State	:	CA
Zip	:	93710-7615
Country	:	US
Telephone Number	:	559-206-5688
Fax Number	:	559-283-8440

Authorized Official
Title or Position	:	OWNER
Name	:	LARRY D SCORTT
Credential	:	DPM
Telephone Number	:	559-206-5688

Provider Enumeration Date	:	11/27/2007
Last Update Date	:	10/25/2019

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Directions to “LARRY SCORTT ” Practice Location

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