Provider Demographics
NPI:1346406899
Name:SCOTT, ANDREA RAE (DO)
Entity Type:Individual
Prefix:DR
First Name:ANDREA
Middle Name:RAE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:4221 S WESTERN AVE
Mailing Address - Street 2:STE 4010
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73109-3447
Mailing Address - Country:US
Mailing Address - Phone:405-644-6464
Mailing Address - Fax:405-644-6465
Practice Address - Street 1:4221 S WESTERN AVE
Practice Address - Street 2:STE 4010
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73109-3447
Practice Address - Country:US
Practice Address - Phone:405-644-6464
Practice Address - Fax:405-644-6465
Is Sole Proprietor?:No
Enumeration Date:2008-08-04
Last Update Date:2016-02-01
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL125-054055207R00000X
OK5509207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine