Provider Demographics
NPI:1992823769
Name:SCOTTON, DAVID (PT)
Entity Type:Individual
Prefix:
First Name:DAVID
Middle Name:
Last Name:SCOTTON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 842
Mailing Address - Street 2:
Mailing Address - City:CHARDON
Mailing Address - State:OH
Mailing Address - Zip Code:44024-0842
Mailing Address - Country:US
Mailing Address - Phone:440-739-4239
Mailing Address - Fax:440-739-4239
Practice Address - Street 1:7580 NORTHCLIFF AVE
Practice Address - Street 2:SUITE 600
Practice Address - City:BROOKLYN
Practice Address - State:OH
Practice Address - Zip Code:44144-3270
Practice Address - Country:US
Practice Address - Phone:216-485-7865
Practice Address - Fax:216-485-7864
Is Sole Proprietor?:No
Enumeration Date:2007-03-27
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH003610225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2938816Medicaid
OHSC4231421Medicare PIN