Individual
SHANNON CAROL SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
19389 N 59TH AVE, GLENDALE, AZ 85308-6500
(623) 537-6000
(623) 537-6014
Mailing address
19555 N 59TH AVE, GLENDALE, AZ 85308-6813
(623) 537-6000
(623) 537-6014
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4309
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
358249
—
AZ
Enumeration date
07/17/2007
Last updated
02/23/2010
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