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Individual

CHARLES W SCOWCROFT

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
225 MEDICAL CENTER DR STE 308, PADUCAH, KY 42003-7915
(270) 443-0777
(270) 443-0999
Mailing address
225 MEDICAL CENTER DR STE 308, PADUCAH, KY 42003-7915
(270) 443-0777
(270) 443-0999

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
11819
SC
207RG0100X
Gastroenterology Physician
Primary
TP500
KY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
118198
SC
Enumeration date
05/24/2006
Last updated
01/11/2019
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