Provider Demographics
NPI:1386845378
Name:SCOTT, GEORGE W II (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:W
Last Name:SCOTT
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2700 STANLEY GAULT PKWY STE 129
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40223-5176
Mailing Address - Country:US
Mailing Address - Phone:502-253-4900
Mailing Address - Fax:502-489-5751
Practice Address - Street 1:3900 KRESGE WAY STE 56
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40207-1144
Practice Address - Country:US
Practice Address - Phone:502-895-7265
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-29
Last Update Date:2020-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY426172084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000057058OtherHUMANA - NNS
KY119124OtherSIHO - NNS
KY7100080280Medicaid
IN201040790Medicaid
KY000000693351OtherANTHEM - NNS
KY50030554OtherPASSPORT & PASSPORT ADVTG - NNS
KYP00885632OtherRAILROAD MEDICARE
KY50030554OtherPASSPORT & PASSPORT ADVTG - NNS
KY000000693351OtherANTHEM - NNS
KY7100080280Medicaid