Provider Demographics
NPI:1922200302
Name:SCOTT, LISBETH ANN (MD)
Entity Type:Individual
Prefix:
First Name:LISBETH
Middle Name:ANN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:112 MULBERRY DRIVE
Mailing Address - Street 2:
Mailing Address - City:MATAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70005
Mailing Address - Country:US
Mailing Address - Phone:504-835-7604
Mailing Address - Fax:
Practice Address - Street 1:112 MULBERRY DRIVE
Practice Address - Street 2:
Practice Address - City:MATAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70005
Practice Address - Country:US
Practice Address - Phone:504-835-7604
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA018302208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics