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Organization

PHOENIX EMERGENCY SERVICES OF MADISON LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. STEVEN M. SCOTT MD (OWNER)
(877) 751-1157
Entity
Organization

Contact information

Practice address
1 KINGS DAUGHTERS DR, PHOENIX EMERGENCY SERVICES OF MADISON, MADISON, IN 47250-3300
(812) 265-5211
Mailing address
2828 CROASDAILE DR, PHOENIX EMERGENCY SERVICES OF MADISON, DURHAM, NC 27705-2505
(877) 751-1157

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
363L00000X
Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00000380234
BLUE CROSS BLUE SHIELD OF IN
IN
05
200540070 A
IN
01
2640517000
PASSPORT HEALTHPLAN ADVANTAGE HMO MEDICARE
KY
01
50009161
PASSPORT HEALTH PLAN
KY
05
65944647
KY
05
78904984
KY
Enumeration date
10/17/2005
Last updated
04/28/2008
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