Provider Demographics
NPI:1508105479
Name:BROWN, SCOTT DUNCAN THOMAS
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DUNCAN THOMAS
Last Name:BROWN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10767 BRENT TOWN RD
Mailing Address - Street 2:
Mailing Address - City:CATLETT
Mailing Address - State:VA
Mailing Address - Zip Code:20119-2409
Mailing Address - Country:US
Mailing Address - Phone:540-295-2047
Mailing Address - Fax:540-788-9144
Practice Address - Street 1:10767 BRENT TOWN RD
Practice Address - Street 2:
Practice Address - City:CATLETT
Practice Address - State:VA
Practice Address - Zip Code:20119-2409
Practice Address - Country:US
Practice Address - Phone:540-295-2047
Practice Address - Fax:540-788-9144
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA2705081290171WH0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications