Individual
SCOTT MORRISON DALE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1490 N TURQUOISE DR, FLAGSTAFF, AZ 86001
(928) 774-5074
(928) 779-0884
Mailing address
1490 N TURQUOISE DR, FLAGSTAFF, AZ 86001
(928) 774-5074
(928) 779-0884
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
30215
AZ
207ND0101X
MOHS-Micrographic Surgery Physician
30215
AZ
207NS0135X
Procedural Dermatology Physician
30215
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
070017035
RXR MEDICARE
AZ
05
—
737611
—
AZ
Enumeration date
07/14/2006
Last updated
01/28/2021
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