Basic Information
| Provider Information | |||||||||
| NPI: | 1144272725 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2209 ESTATE DRIVE | ||||||||
| Address2: | |||||||||
| City: | AUBURN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3343324580 | ||||||||
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| Practice Location | |||||||||
| Address1: | 215 PERRY HILL ROAD | ||||||||
| Address2: | (CENTRAL AL VETERANS HEALTH CARE SYSTEM | ||||||||
| City: | MONTGOMERY | ||||||||
| State: | AL | ||||||||
| PostalCode: | 36109 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3347498303 | ||||||||
| FaxNumber: | 3347455243 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/16/2006 | ||||||||
| LastUpdateDate: | 12/06/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | 0015717 | AL | Y | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
ID Information
| ID | Type | State | Issuer | Description | 51034743SCO | 01 | AL | BLUE CROSS & BLUE SHIELD | OTHER | 000034743 | 05 | AL | MEDICAID | 51098562SCO | 01 | AL | BLUE CROSS & BLUE SHIELD | OTHER | 000098560 | 05 | AL | MEDICAID | 51034744SCO | 01 | AL | BLUE CROSS & BLUE SHIELD | OTHER | 000034744 | 05 | AL | MEDICAID |