MEDICARE: DR. LARRY D SCORTT D.P.M.

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	213E00000X	Podiatrist	E2629	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	:	1538131578
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LARRY D SCORTT D.P.M.

Provider Business Mailing Address
First Line	:	7210 N MILBURN
Second Line	:	SUITE 101
City	:	FRESNO
State	:	CA
Zip	:	93722-0022
Country	:	US
Telephone Number	:	559-224-5101
Fax Number	:	559-224-4396

Provider Business Practice Location Address
First Line	:	7210 N MILBURN AVE
Second Line	:	SUITE 101
City	:	FRESNO
State	:	CA
Zip	:	93722-0022
Country	:	US
Telephone Number	:	559-224-5101
Fax Number	:	559-224-4396

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

Provider Enumeration Date	:	02/03/2006
Last Update Date	:	06/08/2010

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