Provider Demographics
NPI:1760743736
Name:SCOTT, MITCHELL GEORGE (PHD)
Entity Type:Individual
Prefix:PROF
First Name:MITCHELL
Middle Name:GEORGE
Last Name:SCOTT
Suffix:
Gender:M
Credentials:PHD
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Mailing Address - Street 1:12404 MATTHEWS LN
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63127-1346
Mailing Address - Country:US
Mailing Address - Phone:314-843-9130
Mailing Address - Fax:314-362-1461
Practice Address - Street 1:660 S. EUCLID AVE.
Practice Address - Street 2:DIVISION OF LABORATORY MEDICINE BOX 8118
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63110
Practice Address - Country:US
Practice Address - Phone:314-362-1503
Practice Address - Fax:314-362-1461
Is Sole Proprietor?:No
Enumeration Date:2012-06-06
Last Update Date:2012-06-06
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician