Provider Demographics
NPI:1477531259
Name:BELHAM, SCOTT JAMES (ATC, OPA-C)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:JAMES
Last Name:BELHAM
Suffix:
Gender:M
Credentials:ATC, OPA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12356 WINDANCE DR
Mailing Address - Street 2:
Mailing Address - City:GULFPORT
Mailing Address - State:MS
Mailing Address - Zip Code:39503-7778
Mailing Address - Country:US
Mailing Address - Phone:228-547-0318
Mailing Address - Fax:228-831-0318
Practice Address - Street 1:12356 WINDANCE DR
Practice Address - Street 2:
Practice Address - City:GULFPORT
Practice Address - State:MS
Practice Address - Zip Code:39503-7778
Practice Address - Country:US
Practice Address - Phone:228-547-0318
Practice Address - Fax:228-831-0318
Is Sole Proprietor?:No
Enumeration Date:2006-01-03
Last Update Date:2014-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSAT00512255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer