Individual
JAMES DAVID SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
(304) 438-6819
Mailing address
176 MEDICAL CENTER DR, RAINELLE, WV 25962-1064
(304) 438-6188
(304) 438-6819
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
102050207
VA
207Q00000X
Family Medicine Physician
Primary
1725
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11159994
CAQH ID #
—
01
—
1722722
MTN STATE BCBS
WV
01
—
453333
ANTHEM
—
01
—
55-0779928
FEIN
—
05
—
5630372000
—
WV
Enumeration date
07/07/2006
Last updated
06/26/2018
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