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Individual

KEVIN PATRICK SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
500 W BROADWAY ST FL 3, MISSOULA, MT 59802-4008
(406) 327-1670
(406) 329-5697
Mailing address
PO BOX 12, LIBERTY LAKE, WA 99019-0012
(406) 327-1670
(406) 329-5697

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MED-PAC-LIC-133
MT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0437138
MT
Enumeration date
07/13/2006
Last updated
03/07/2023
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