Provider Demographics
NPI:1265508493
Name:WHITTEN, SCOTT JASON (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JASON
Last Name:WHITTEN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:645 SIERRA ROSE DR
Mailing Address - Street 2:SUITE 205
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89511-2060
Mailing Address - Country:US
Mailing Address - Phone:775-828-1200
Mailing Address - Fax:775-828-1785
Practice Address - Street 1:645 SIERRA ROSE DR
Practice Address - Street 2:SUITE 205
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89511-2060
Practice Address - Country:US
Practice Address - Phone:775-828-1200
Practice Address - Fax:775-828-1785
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NV11848207VE0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VE0102XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyReproductive Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVH81058Medicare UPIN