Provider Demographics
NPI:1508210337
Name:DOUGLAS, SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:DOUGLAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:237 WILLIAM HOWARD TAFT RD
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2610
Mailing Address - Country:US
Mailing Address - Phone:513-351-9900
Mailing Address - Fax:513-366-4491
Practice Address - Street 1:2123 AUBURN AVE STE A28
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219
Practice Address - Country:US
Practice Address - Phone:513-585-2472
Practice Address - Fax:513-585-4094
Is Sole Proprietor?:No
Enumeration Date:2016-04-18
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35.136240207R00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine