Provider Demographics
NPI:1083218937
Name:SCOTT, BUTCH JEROME
Entity Type:Individual
Prefix:
First Name:BUTCH
Middle Name:JEROME
Last Name:SCOTT
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 WESTERN AVE
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:OH
Mailing Address - Zip Code:43140-1308
Mailing Address - Country:US
Mailing Address - Phone:740-506-4281
Mailing Address - Fax:
Practice Address - Street 1:163 WESTERN AVE
Practice Address - Street 2:
Practice Address - City:LONDON
Practice Address - State:OH
Practice Address - Zip Code:43140-1308
Practice Address - Country:US
Practice Address - Phone:740-506-4281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-22
Last Update Date:2020-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health