Provider Demographics
NPI:1548242100
Name:SCOTT, KIRBY J (DO)
Entity Type:Individual
Prefix:DR
First Name:KIRBY
Middle Name:J
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:1800 DUAL HWY
Mailing Address - Street 2:SUITE #303
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-6602
Mailing Address - Country:US
Mailing Address - Phone:301-739-0400
Mailing Address - Fax:301-739-0402
Practice Address - Street 1:1800 DUAL HWY
Practice Address - Street 2:SUITE #303
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-6602
Practice Address - Country:US
Practice Address - Phone:301-739-0400
Practice Address - Fax:301-739-0402
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2012-10-24
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
PAOS-008770-L207Y00000X
VA0102050002207Y00000X
MDH0064647207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology