Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | DO1091 | TN |
Y | 207QG0300X | Family Doctor - Geriatric Medicine | DO 1091 | TN |
NPI | 1063429546 |
---|---|
Provider Name | Dr. Joyce Elaine Scott |
First Address | Celina, TN 38551-6144 |
Second Address | Celina, TN 38551-6144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2006 |
Last Update Date | 23/12/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
3091574 | BCBSTN (01) | TN |
3284803 | (05) | TN |
G10130 | (02) | TN |