Provider Demographics
NPI:1356310403
Name:SCOTT, MELINDA A (DO)
Entity Type:Individual
Prefix:DR
First Name:MELINDA
Middle Name:A
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7980 N. MAIN ST.
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45415-2328
Mailing Address - Country:US
Mailing Address - Phone:937-771-0519
Mailing Address - Fax:937-771-0544
Practice Address - Street 1:7980 N. MAIN ST.
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45415-2328
Practice Address - Country:US
Practice Address - Phone:937-771-0519
Practice Address - Fax:937-771-0544
Is Sole Proprietor?:No
Enumeration Date:2006-03-14
Last Update Date:2011-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007677207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2423925Medicaid
OHP00456726OtherMEDICARE RR
H93401Medicare UPIN
OH4115553Medicare PIN