Provider Demographics
NPI:1043355936
Name:SCOTLAND FAMILY MEDICINE INC
Entity Type:Organization
Organization Name:SCOTLAND FAMILY MEDICINE INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:W
Authorized Official - Last Name:RICTOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:717-267-3606
Mailing Address - Street 1:PO BOX 398
Mailing Address - Street 2:
Mailing Address - City:SCOTLAND
Mailing Address - State:PA
Mailing Address - Zip Code:17254-0398
Mailing Address - Country:US
Mailing Address - Phone:717-267-3606
Mailing Address - Fax:717-267-0443
Practice Address - Street 1:3730 SCOTLAND ROAD
Practice Address - Street 2:
Practice Address - City:SCOTLAND
Practice Address - State:PA
Practice Address - Zip Code:17254
Practice Address - Country:US
Practice Address - Phone:717-267-3606
Practice Address - Fax:717-267-0443
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-20
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD036568E261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA845705Medicare PIN