Provider Demographics
NPI:1962444844
Name:SHEARER, SCOTT ANTHONY (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANTHONY
Last Name:SHEARER
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 1:5996 ROCKY RILL RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43235-3320
Mailing Address - Country:US
Mailing Address - Phone:614-310-5689
Mailing Address - Fax:
Practice Address - Street 1:5791 CLEVELAND AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43231-2831
Practice Address - Country:US
Practice Address - Phone:614-901-9695
Practice Address - Fax:614-901-9720
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3248111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2300825Medicaid
OH000000351712OtherBLUE CROSS/BLUESHIELD
OH664818OtherACN
OH4071861Medicare ID - Type Unspecified