Provider Demographics
NPI:1346503380
Name:SCOTT, JOSEPH D (DO)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:D
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DO
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Mailing Address - Street 1:300 SOUTHBOROUGH DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SOUTH PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04106-6914
Mailing Address - Country:US
Mailing Address - Phone:207-661-2018
Mailing Address - Fax:207-661-2033
Practice Address - Street 1:2 SPRINGBROOK DR
Practice Address - Street 2:
Practice Address - City:BIDDEFORD
Practice Address - State:ME
Practice Address - Zip Code:04005-9443
Practice Address - Country:US
Practice Address - Phone:207-282-1500
Practice Address - Fax:207-282-2581
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2017-01-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MEDO26322084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MEE400323480Medicare PIN