Individual
MR. EDWARD LEE SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, OCS
Contact information
Practice address
2600 GREENBUSH ST, LAFAYETTE, IN 47904-2479
(765) 448-8000
Mailing address
PO BOX 5545, LAFAYETTE, IN 47903-5545
(765) 448-8000
(765) 448-8335
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
05002042A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000528618
ANTHEM PROVIDER NUMBER
IN
05
—
200896760
—
IN
Enumeration date
10/31/2006
Last updated
10/15/2018
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