Provider Demographics
NPI:1164401436
Name:CONLEY, SCOTT C (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:C
Last Name:CONLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:418 CLOVERLEAF RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:17022-9320
Mailing Address - Country:US
Mailing Address - Phone:717-653-1467
Mailing Address - Fax:717-653-1001
Practice Address - Street 1:418 CLOVERLEAF RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:PA
Practice Address - Zip Code:17022-9320
Practice Address - Country:US
Practice Address - Phone:717-653-1467
Practice Address - Fax:717-653-1001
Is Sole Proprietor?:No
Enumeration Date:2006-01-13
Last Update Date:2007-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD069993L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA154749OtherHIGHMARK BLUE SHIELD
PA2328248OtherAETNA HMO
PA50001037OtherCAPITAL BLUE CROSS
PAH13293OtherHEALTH ASSURANCE
PA0017932810005Medicaid
PA0017932810003Medicaid
PA7067096OtherAETNA NON-HMO
PAP004530OtherGATEWAY HEALTH PLAN
PA75154 S101OtherGEISINGER HEALTH PLAN
PA75154 S101OtherGEISINGER HEALTH PLAN
PA036930L4VMedicare PIN