Basic Information
| Provider Information | |||||||||
| NPI: | 1669646998 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SCOTT | ||||||||
| FirstName: | JOHN | ||||||||
| MiddleName: | W | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1430 TULANE AVE., SL79 | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049885224 | ||||||||
| FaxNumber: | 5049887389 | ||||||||
| Practice Location | |||||||||
| Address1: | 1430 TULANE AVE., SL79 | ||||||||
| Address2: | |||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70112 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5049885224 | ||||||||
| FaxNumber: | 5049887389 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/17/2008 | ||||||||
| LastUpdateDate: | 04/17/2008 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207ZC0006X | MD.11107R | LA | Y | Allopathic & Osteopathic Physicians | Pathology | Clinical Pathology |
No ID Information.