Provider Demographics
NPI:1285664839
Name:MCLAIN, SCOTT D (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:MCLAIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1526 BRIDGEWATER LN
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-4106
Mailing Address - Country:US
Mailing Address - Phone:423-246-0033
Mailing Address - Fax:423-245-0034
Practice Address - Street 1:1526 BRIDGEWATER LN
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-4106
Practice Address - Country:US
Practice Address - Phone:423-246-0033
Practice Address - Fax:423-245-0034
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD39507207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNCA7108OtherRAILROAD MEDICARE
TNCA7108OtherRAILROAD MEDICARE
TNI27789Medicare UPIN