Provider Demographics
NPI:1326019050
Name:HORTON, SCOTT L (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:L
Last Name:HORTON
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 1:74 PLEASANT STREET
Mailing Address - Street 2:STE 204
Mailing Address - City:NEW LONDON
Mailing Address - State:NH
Mailing Address - Zip Code:03257
Mailing Address - Country:US
Mailing Address - Phone:603-526-4635
Mailing Address - Fax:603-526-8283
Practice Address - Street 1:240 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WOLFEBORO
Practice Address - State:NH
Practice Address - Zip Code:03894-4411
Practice Address - Country:US
Practice Address - Phone:603-569-7500
Practice Address - Fax:603-515-2031
Is Sole Proprietor?:No
Enumeration Date:2006-01-31
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH7572207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH3079506Medicaid
NH0105252Y0NH01OtherANTHEM
NH0105252Y0NH01OtherANTHEM
NH3079506Medicaid
NHNH9392Medicare ID - Type Unspecified