MEDICARE: SCOTT C SCOGGINS MD

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	9501407	NC
2	207Q00000X	Family Medicine Physician	ME168847	FL

General Provider Information

NPI Number	:	1699771014
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT C SCOGGINS MD

Provider Business Mailing Address
First Line	:	15000 SHELL POINT BLVD STE 100
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-1657
Country	:	US
Telephone Number	:	239-454-2146
Fax Number	:	239-466-2111

Provider Business Practice Location Address
First Line	:	13880 SHELL POINT PLZ STE 110
Second Line	:
City	:	FORT MYERS
State	:	FL
Zip	:	33908-3504
Country	:	US
Telephone Number	:	239-454-2146
Fax Number	:

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

Provider Enumeration Date	:	06/21/2005
Last Update Date	:	09/25/2024

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Directions to “ SCOTT C SCOGGINS MD” Practice Location

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