Individual
MARK SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
65 PROFESSIONAL PL STE 102103, BRIDGEPORT, WV 26330-0258
(304) 848-5770
(304) 848-0890
Mailing address
65 PROFESSIONAL PL STE 102103, BRIDGEPORT, WV 26330-0258
(304) 848-5770
(304) 848-0890
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
2012025740
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992057277
—
WV
Enumeration date
10/10/2012
Last updated
09/07/2022
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