Provider Demographics
NPI:1326018359
Name:BINGHAM, SCOTT D (DO)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:D
Last Name:BINGHAM
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5410 W THUNDERBIRD RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85306-4711
Mailing Address - Country:US
Mailing Address - Phone:602-530-6189
Mailing Address - Fax:602-548-2292
Practice Address - Street 1:5410 W THUNDERBIRD RD
Practice Address - Street 2:SUITE 101
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85306-4711
Practice Address - Country:US
Practice Address - Phone:602-530-6189
Practice Address - Fax:602-548-2292
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZ2919207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine