Provider Demographics
NPI:1689601072
Name:SCOTT, WILLIAM GEOFFREY (MD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:GEOFFREY
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 BOOTH CALLOWAY ROAD
Mailing Address - Street 2:SUITE 400
Mailing Address - City:NORHT RICHLAND HILLS
Mailing Address - State:TX
Mailing Address - Zip Code:76180-7369
Mailing Address - Country:US
Mailing Address - Phone:817-595-3700
Mailing Address - Fax:817-595-3701
Practice Address - Street 1:4351 BOOTH CALLOWAY ROAD
Practice Address - Street 2:SUITE 400
Practice Address - City:NORTH RICHLAND HILLS
Practice Address - State:TX
Practice Address - Zip Code:76180-7369
Practice Address - Country:US
Practice Address - Phone:817-595-3700
Practice Address - Fax:817-595-3701
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2009-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS31244207Y00000X
TXN2290207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS200310510AMedicaid
KS207905OtherHPK
KS104530OtherBCBS
KS234563OtherCOVENTRY
KS8731OtherPHS
KS207905OtherHPK
KS104530OtherBCBS