Provider Demographics
NPI:1063471167
Name:SCOTT, VICKY M (DO)
Entity Type:Individual
Prefix:
First Name:VICKY
Middle Name:M
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 BERRY HILL DR
Mailing Address - Street 2:
Mailing Address - City:HENDERSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28791-8207
Mailing Address - Country:US
Mailing Address - Phone:828-691-8463
Mailing Address - Fax:
Practice Address - Street 1:116 BERRY HILL DR
Practice Address - Street 2:
Practice Address - City:HENDERSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28791-8207
Practice Address - Country:US
Practice Address - Phone:828-691-8463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-20
Last Update Date:2014-02-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC36483207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
2183675AMedicare ID - Type Unspecified
NC89-75079Medicare ID - Type Unspecified
F52397Medicare UPIN