Provider Demographics
NPI:1043288558
Name:SIBLEY, SCOTT O (MT(ASCP))
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:O
Last Name:SIBLEY
Suffix:
Gender:M
Credentials:MT(ASCP)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 WRIGHT AVE
Mailing Address - Street 2:
Mailing Address - City:CROWLEY
Mailing Address - State:LA
Mailing Address - Zip Code:70526-2220
Mailing Address - Country:US
Mailing Address - Phone:337-783-7337
Mailing Address - Fax:337-783-1022
Practice Address - Street 1:1455 WRIGHT AVE
Practice Address - Street 2:
Practice Address - City:CROWLEY
Practice Address - State:LA
Practice Address - Zip Code:70526-2220
Practice Address - Country:US
Practice Address - Phone:337-783-7337
Practice Address - Fax:337-783-1022
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LAG03424246QM0706X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist