Provider Demographics
NPI:1568769214
Name:SCOTT, EDGAR JAMES II (MS)
Entity Type:Individual
Prefix:MR
First Name:EDGAR
Middle Name:JAMES
Last Name:SCOTT
Suffix:II
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8309 NW 86TH ST
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73132-3234
Mailing Address - Country:US
Mailing Address - Phone:405-503-8935
Mailing Address - Fax:
Practice Address - Street 1:8309 NW 86TH ST
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73132-3234
Practice Address - Country:US
Practice Address - Phone:405-503-8935
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-02-15
Last Update Date:2011-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst