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NPI Code Detail

MEDICARE: DR. SCOTT JAMES CARMACK D.C.

MEDICARE: DR. SCOTT JAMES CARMACK D.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
1111N00000XChiropractorCH00034056WA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AB29040OTHERWAMEDICARE INDIVIUAL
2AB29039OTHERWAMEDICARE GROUP

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4U87239OTHERWAUPIN

General Provider Information

NPI Number : 1972597391
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. SCOTT JAMES CARMACK D.C.
Provider Business Mailing Address
First Line : PO BOX 1841
Second Line :
City : ZILLAH
State : WA
Zip : 98953-1841
Country : US
Telephone Number : 509-829-6101
Fax Number : 509-829-6101
Provider Business Practice Location Address
First Line : 513 1ST AVE
Second Line :
City : ZILLAH
State : WA
Zip : 98953-9432
Country : US
Telephone Number : 509-829-6101
Fax Number : 509-829-6101
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2005
Last Update Date : 03/28/2008

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