Provider Demographics
NPI:1093797391
Name:SCOTT, JUNE YI (MD)
Entity Type:Individual
Prefix:
First Name:JUNE
Middle Name:YI
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 110429
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:CO
Mailing Address - Zip Code:80042-0429
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2655 CRESCENT DR
Practice Address - Street 2:SUITE D
Practice Address - City:LAFAYETTE
Practice Address - State:CO
Practice Address - Zip Code:80026-3372
Practice Address - Country:US
Practice Address - Phone:303-443-4200
Practice Address - Fax:303-443-5470
Is Sole Proprietor?:No
Enumeration Date:2005-11-14
Last Update Date:2023-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO36460174400000X, 207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01364603Medicaid
CO1093797391OtherNPI
COP00080043OtherRR MEDICARE
CO01364603Medicaid
COCO305908Medicare PIN