Organization
SCOTT W SOUTHARD MD INC
Active
Organization
SCOTT W SOUTHARD MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KATHY BARELA (OFFICE MANAGER)
(530) 541-4119
Entity
Organization
Contact information
Practice address
1520 VIRGINIA RANCH RD STE 1B, GARDNERVILLE, NV 89410-5732
(530) 541-4119
(530) 541-3246
Mailing address
1520 VIRGINIA RANCH RD STE 1B, GARDNERVILLE, NV 89410-5732
(530) 541-4119
(530) 541-3246
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
6292
NV
207X00000X
Orthopaedic Surgery Physician
G60029
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002003053
—
NV
Enumeration date
02/10/2009
Last updated
01/17/2019
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