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Individual

MCKENNETH SCOTT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHYSICIANS ASSISTANT

Contact information

Practice address
1750 TOMCAT BLVD, VIRGINIA BEACH, VA 23460-2168
(757) 953-3933
(757) 953-3890
Mailing address
620 JOHN PAUL JONES CIR, PORTSMOUTH, VA 23708-2111
(757) 953-3933
(757) 953-3890

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
006243
NY
363AM0700X
Medical Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01903075
NY
Enumeration date
07/12/2006
Last updated
01/17/2025
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