1154451862 NPI number — MS. DAWN MARIE SCOTT PA-C

Table of content: MS. DAWN MARIE SCOTT PA-C (NPI 1154451862)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1154451862 NPI number — MS. DAWN MARIE SCOTT PA-C

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCOTT
Provider First Name:
DAWN
Provider Middle Name:
MARIE
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PA-C
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CUNNINGHAM
Provider Other First Name:
DAWN
Provider Other Middle Name:
MARIE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
PA-C
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1154451862
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/18/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1901 VETERANS MEMORIAL DR
Provider Second Line Business Mailing Address:
GASTROENTEROLOGY SERVICE
Provider Business Mailing Address City Name:
TEMPLE
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
76504-7451
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
254-743-2285
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1901 VETERANS MEMORIAL DR
Provider Second Line Business Practice Location Address:
GASTROENTEROLOGY SERVICE
Provider Business Practice Location Address City Name:
TEMPLE
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
76504-7451
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
254-743-2285
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/06/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363AM0700X , with the licence number:  102767 , registered in the state of NC ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)