Individual
JOHN SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
333 N 1ST ST STE 250, BOISE, ID 83702-6132
(208) 381-9384
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8866
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
01030263
IN
2085N0700X
Neuroradiology Physician
Primary
M-16869
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100358340
—
IN
Enumeration date
06/22/2005
Last updated
10/25/2022
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