Provider Demographics
NPI:1225197171
Name:JAMESON, SCOTT D (CPO, LPO)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:JAMESON
Suffix:
Gender:M
Credentials:CPO, LPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 SUNDANCE RD.
Mailing Address - Street 2:
Mailing Address - City:ABILENE
Mailing Address - State:TX
Mailing Address - Zip Code:79602
Mailing Address - Country:US
Mailing Address - Phone:325-793-9434
Mailing Address - Fax:325-793-3582
Practice Address - Street 1:4601 HARTFORD
Practice Address - Street 2:
Practice Address - City:ABILENE
Practice Address - State:TX
Practice Address - Zip Code:79605-4603
Practice Address - Country:US
Practice Address - Phone:325-793-3400
Practice Address - Fax:325-793-3587
Is Sole Proprietor?:No
Enumeration Date:2006-12-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1045111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic