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Individual

DR. GLEN R SCOTT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
146 E HOSPITAL DR STE 120A, WEST COLUMBIA, SC 29169-4800
(803) 936-7076
(803) 936-7925
Mailing address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2000
(864) 366-9012

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
0590
SC
2084N0400X
Neurology Physician
Primary
590
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0590
SC
Enumeration date
07/07/2006
Last updated
01/18/2024
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