Provider Demographics
NPI:1134013345
Name:SCOTT, FREDDIE LEE JR (AED/CPR CERT)
Entity type:Individual
Prefix:MR
First Name:FREDDIE
Middle Name:LEE
Last Name:SCOTT
Suffix:JR
Gender:M
Credentials:AED/CPR CERT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3325 W 10TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46222-3524
Mailing Address - Country:US
Mailing Address - Phone:317-533-8540
Mailing Address - Fax:
Practice Address - Street 1:3325 W 10TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46222-3524
Practice Address - Country:US
Practice Address - Phone:317-533-8540
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator