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Individual

SCOTT D GILLETTE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
525 E MARKET ST, AKRON, OH 44304-1619
(330) 375-3765
(330) 375-7586
Mailing address
PO BOX 2090, AKRON, OH 44309-2090
(330) 375-3765
(330) 375-7586

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
157695
NC
367500000X
Certified Registered Nurse Anesthetist
Primary
RN-256368
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000357686
ANTHEM BCBS INDV NUMBER
OH
01
100153
EMPLOYER KAISER GROUP #
OH
01
2080224
UNITED HEALTHCARE GROUP #
OH
05
2541084
OH
01
34-0891295
EMPLOYER FEDERAL TAX ID #
OH
05
7091249
OH
01
730554
BUCKEYE COMMUNITY HLTH PL
OH
Enumeration date
05/05/2006
Last updated
02/13/2018
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