Individual
SCOTT DAVID JAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
2428 KNOB CREEK ROAD, JOHNSON CITY, TN 37604
(423) 282-5054
(423) 282-0981
Mailing address
105 W STONE DR, SUITE 6A, KINGSPORT, TN 37660-3365
(423) 408-7220
(423) 408-7405
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2002017394
MO
207RC0000X
Cardiovascular Disease Physician
2002017394
MO
207RC0000X
Cardiovascular Disease Physician
Primary
45843
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
205889413
—
MO
Enumeration date
08/30/2006
Last updated
12/03/2014
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