Provider Demographics
NPI:1649216052
Name:COURTLEY, SCOTT A (DC)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:COURTLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11921 KINGSTON PIKE STE 102
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37934-4844
Mailing Address - Country:US
Mailing Address - Phone:865-986-8088
Mailing Address - Fax:865-986-5400
Practice Address - Street 1:11921 KINGSTON PIKE STE 102
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37934-4844
Practice Address - Country:US
Practice Address - Phone:865-986-8088
Practice Address - Fax:865-986-5400
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDC0000001326111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3044726OtherBCBS
TN3678649Medicare PIN