Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NX0800X | Chiropractor Orthopedic Specialist | 08001131A | IN |
NPI | 1619941507 |
---|---|
Provider Name | Dr. Scott A Molin |
First Address | Crawfordsville, IN 47933-1043 |
Second Address | Crawfordsville, IN 47933-1043 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2006 |
Last Update Date | 04/09/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000000090250 | ANTHEM/BC/BS # (01) | IN |
100185720A | (05) | IN |
350056122 | RAILROAD MEDICARE (01) | IN |
T34935 | (02) | IN |