Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 01041529B | IN |
Y | 207YX0007X | Plastic Surgeon (Head & Neck) | 29592 | KY |
NPI | 1881692317 |
---|---|
Provider Name | Bruce A Scott |
First Address | Louisville, KY 40205-3372 |
Second Address | Louisville, KY 40205-3372 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2005 |
Last Update Date | 12/01/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000045446 | ANTHEM FACET NUMBER (01) | KY |
04006864 | RAIL ROAD MEDICARE (01) | KY |
100347690A | (05) | IN |
64295926 | (05) | KY |
F57246 | (02) | KY |