Provider Demographics
NPI:1114163060
Name:SESSIONS, SCOTT CLARK (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:CLARK
Last Name:SESSIONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5565 GROSSMONT CENTRE DRIVE
Mailing Address - Street 2:SUITE 120 BLDG 1
Mailing Address - City:LA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:91942
Mailing Address - Country:US
Mailing Address - Phone:619-463-8878
Mailing Address - Fax:619-463-8870
Practice Address - Street 1:5565 GROSSMONT CTR DR
Practice Address - Street 2:STE 120
Practice Address - City:LA MESA
Practice Address - State:CA
Practice Address - Zip Code:91941
Practice Address - Country:US
Practice Address - Phone:619-463-8878
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-24
Last Update Date:2008-12-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG084594208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery