MEDICARE: DR. JEFFREY DOUGLAS 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	2081P2900X	Pain Medicine (Physical Medicine & Rehabilitation) Physician	40645	AZ

General Provider Information

NPI Number	:	1619998168
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JEFFREY DOUGLAS SCOTT M.D.

Provider Business Mailing Address
First Line	:	3417 N 32ND ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5606
Country	:	US
Telephone Number	:	602-368-3600
Fax Number	:	602-368-3235

Provider Business Practice Location Address
First Line	:	3417 N 32ND ST
Second Line	:
City	:	PHOENIX
State	:	AZ
Zip	:	85018-5606
Country	:	US
Telephone Number	:	602-368-3600
Fax Number	:	602-368-3235

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

Provider Enumeration Date	:	07/21/2006
Last Update Date	:	05/12/2026

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