Provider Demographics
NPI:1497720346
Name:DANNATT, SCOTT JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:JAMES
Last Name:DANNATT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18562 W FAIRWAY DR
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85374-3910
Mailing Address - Country:US
Mailing Address - Phone:623-815-2491
Mailing Address - Fax:623-977-5762
Practice Address - Street 1:18562 W FAIRWAY DR
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3910
Practice Address - Country:US
Practice Address - Phone:623-815-2491
Practice Address - Fax:623-977-5762
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-22
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7631111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZU62824Medicare UPIN
AZ105919Medicare ID - Type Unspecified