Individual
SCOTT JAMES BRICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
13778 PLANTATION RD, FORT MYERS, FL 33912-4301
(239) 343-0454
(239) 343-1075
Mailing address
PO BOX 2147, FORT MYERS, FL 33902-2147
(239) 343-0454
(239) 343-1075
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
2010003178
MO
208600000X
Surgery Physician
Primary
OS15228
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1164744199
—
MO
05
—
116550500
—
FL
01
—
135570024
MEDICARE PTAN
MO
01
—
2010003178
MO LICENSE
MO
01
—
P00853877
RAIL ROAD MEDICARE
MO
Enumeration date
02/18/2010
Last updated
02/24/2023
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