Individual
MICHAEL D SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4017 RAWLINS ST, CHEYENNE, WY 82001-1800
(307) 635-2562
(307) 637-2867
Mailing address
4136B LARAMIE STREET, CHEYENNE, WY 82001-1969
(307) 637-2800
(307) 637-2867
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA208
WY
363AS0400X
Surgical Physician Assistant
Primary
208
WY
363AS0400X
Surgical Physician Assistant
PA-2238
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
111303800
—
WY
01
—
311196
BLUE CROSS BLUE SHIELD
WY
01
—
970026026
RAIL ROAD MEDICARE
WY
Enumeration date
10/16/2006
Last updated
11/07/2022
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