Basic Information
| Provider Information | |||||||||
| NPI: | 1639335367 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | BRUCE | ||||||||
| MiddleName: | HILLMAN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 95 LEONARD AVENUE | ||||||||
| Address2: | BULIDING 2 2ND FLOOR | ||||||||
| City: | WASHINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153013368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242233100 | ||||||||
| FaxNumber: | 7242233353 | ||||||||
| Practice Location | |||||||||
| Address1: | 95 LEONARD AVENUE | ||||||||
| Address2: | BUILDING 2 2ND FLOOR | ||||||||
| City: | WASHINGTON | ||||||||
| State: | PA | ||||||||
| PostalCode: | 153013368 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7242233100 | ||||||||
| FaxNumber: | 7242233353 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/01/2008 | ||||||||
| LastUpdateDate: | 07/21/2022 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 35-098744 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RG0300X | 35.098744 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Geriatric Medicine | 207RH0002X | 35.098744 | OH | N | Allopathic & Osteopathic Physicians | Internal Medicine | Hospice and Palliative Medicine | 207Q00000X | MD462644 | PA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 0063520 | 05 | OH | MEDICAID | H178261 | 01 | OH | MEDICARE PIN FIVE RIVERS HEALTH CENTERS | OTHER |