Individual
DR. SCOTT WILLIAM NIEL MOLLISON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
22567 SUMMIT DR BLDG 2, WATERTOWN, NY 13601-7210
(315) 779-6784
(315) 779-6799
Mailing address
22567 SUMMIT DR BLDG II, WATERTOWN, NY 13601-7210
(315) 779-6784
(315) 779-6799
Taxonomy
Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
294894
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
294894
MEDICAL LICENSE
NY
Enumeration date
09/27/2018
Last updated
01/21/2021
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