Provider Demographics
NPI:1578909644
Name:SCOTT, SHEYENNE (MD)
Entity Type:Individual
Prefix:
First Name:SHEYENNE
Middle Name:
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3601 4TH ST
Mailing Address - Street 2:STOP 8312
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-0002
Mailing Address - Country:US
Mailing Address - Phone:806-743-2373
Mailing Address - Fax:806-743-4354
Practice Address - Street 1:3601 4TH ST
Practice Address - Street 2:STOP 8312
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-0002
Practice Address - Country:US
Practice Address - Phone:806-743-2373
Practice Address - Fax:806-743-4354
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-16
Last Update Date:2013-05-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TXBP1-0046046208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery