Provider Demographics
NPI:1184643546
Name:SCOTT, THOMAS H (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:H
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 PLEASANT ST
Mailing Address - Street 2:STE 204
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257-5881
Mailing Address - Country:US
Mailing Address - Phone:603-421-2220
Mailing Address - Fax:603-421-2223
Practice Address - Street 1:1 PARKLAND DR
Practice Address - Street 2:
Practice Address - City:DERRY
Practice Address - State:NH
Practice Address - Zip Code:03038-2746
Practice Address - Country:US
Practice Address - Phone:603-421-2220
Practice Address - Fax:603-421-2223
Is Sole Proprietor?:No
Enumeration Date:2006-07-18
Last Update Date:2017-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11677207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
44290OtherHARVARD PILGRIM
458293OtherTUFTS
7998178OtherAETNA
42682OtherBMC HEALTHNET PLAN
NH7998178OtherAETNA
P00182391OtherRAILROAD MEDICARE
NH04Y003855NH02OtherANTHEM
NH30222186Medicaid
MA2093120Medicaid
MA2093120Medicaid
NHRE6785Medicare PIN
458293OtherTUFTS