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Individual

DAVID RANDOLPH SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
10243 ROGERS DRIVE, NASSAWADOX, VA 23413
(757) 442-6719
(757) 442-7375
Mailing address
PO BOX 836, NASSAWADOX, VA 23413-0836
(757) 442-6719
(757) 442-7375

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
0101042418
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
006200907
VA
01
051671
ANTHEM BC/BS OF VA
VA
01
322091
ANTHEM BC/BS OF VA
VA
01
52411
OPTIMA HEALTH
VA
01
C02245
MEDICARE PTAN
VA
01
C05079
MEDICARE PTAN
VA
01
CN3911
RAILROAD MEDICARE PTAN
VA
Enumeration date
03/20/2006
Last updated
05/07/2008
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