Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223S0112X | Oral and Maxillofacial Surgeon | 18727 | TX |
NPI | 1003879156 |
---|---|
Provider Name | Dr. Kirk Scott |
First Address | Frisco, TX 75034-4274 |
Second Address | Frisco, TX 75034-4274 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2006 |
Last Update Date | 28/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U92796 | (02) | TX |