MEDICARE: SCOTT L MOREY PA-C

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	363AS0400X	Surgical Physician Assistant	268	WY
2	363AM0700X	Medical Physician Assistant	268	WY

General Provider Information

NPI Number	:	1912960667
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT L MOREY PA-C

Provider Business Mailing Address
First Line	:	1898 FORT RD
Second Line	:
City	:	SHERIDAN
State	:	WY
Zip	:	82801-8320
Country	:	US
Telephone Number	:	307-672-3473
Fax Number	:

Provider Business Practice Location Address
First Line	:	1898 FORT RD
Second Line	:
City	:	SHERIDAN
State	:	WY
Zip	:	82801-8320
Country	:	US
Telephone Number	:	307-672-3473
Fax Number	:

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

Provider Enumeration Date	:	04/11/2006
Last Update Date	:	07/09/2020

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Directions to “ SCOTT L MOREY PA-C” Practice Location

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