Provider Demographics
NPI:1376031450
Name:NORTH-SCOTT, MARIA (DO)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:NORTH-SCOTT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:
Other - Last Name:NORTH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:6300 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:ZACHARY
Mailing Address - State:LA
Mailing Address - Zip Code:70791-4037
Mailing Address - Country:US
Mailing Address - Phone:225-658-4000
Mailing Address - Fax:
Practice Address - Street 1:2335 CHURCH ST STE E
Practice Address - Street 2:
Practice Address - City:ZACHARY
Practice Address - State:LA
Practice Address - Zip Code:70791-2700
Practice Address - Country:US
Practice Address - Phone:225-654-3607
Practice Address - Fax:225-658-2262
Is Sole Proprietor?:No
Enumeration Date:2018-04-25
Last Update Date:2021-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
LA328412207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX1204821433Medicaid