Provider Demographics
NPI:1710515192
Name:SCOTT, MELANIE MARIE (DO)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:MARIE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:MELANIE
Other - Middle Name:MARIE
Other - Last Name:HAGAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2831 FORT MISSOULA RD
Mailing Address - Street 2:BUILDING 2, SUITE 146
Mailing Address - City:MISSOULA
Mailing Address - State:MT
Mailing Address - Zip Code:59804
Mailing Address - Country:US
Mailing Address - Phone:406-327-3850
Mailing Address - Fax:406-327-3851
Practice Address - Street 1:2230 N RESERVE ST STE 402
Practice Address - Street 2:
Practice Address - City:MISSOULA
Practice Address - State:MT
Practice Address - Zip Code:59808-1364
Practice Address - Country:US
Practice Address - Phone:406-493-3120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-31
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT118724207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine