Provider Demographics
NPI:1063638245
Name:GIRCSIS, SCOT (DC)
Entity Type:Individual
Prefix:
First Name:SCOT
Middle Name:
Last Name:GIRCSIS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1367 GEORGESVILLE RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43228
Mailing Address - Country:US
Mailing Address - Phone:614-274-7500
Mailing Address - Fax:614-274-7599
Practice Address - Street 1:1367 GEORGESVILLE RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43228
Practice Address - Country:US
Practice Address - Phone:614-274-7500
Practice Address - Fax:614-274-7599
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2014-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH2795111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2142685Medicaid
OH2142685Medicaid