Provider Demographics
NPI:1639116643
Name:SCOTT, SAMUEL EUGENE (DPM)
Entity Type:Individual
Prefix:
First Name:SAMUEL
Middle Name:EUGENE
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6719 GOVERNOR G. C. PEERY HWY
Mailing Address - Street 2:SUITE 3800
Mailing Address - City:RICHLANDS
Mailing Address - State:VA
Mailing Address - Zip Code:24641-2197
Mailing Address - Country:US
Mailing Address - Phone:276-596-9346
Mailing Address - Fax:276-596-9348
Practice Address - Street 1:6719 GOVERNOR G. C. PEERY HWY
Practice Address - Street 2:SUITE 3800
Practice Address - City:RICHLANDS
Practice Address - State:VA
Practice Address - Zip Code:24641-2197
Practice Address - Country:US
Practice Address - Phone:276-596-9346
Practice Address - Fax:276-596-9348
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-31
Last Update Date:2022-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103300952213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery