Provider Demographics
NPI:1003919812
Name:SCOTT, JOSEPH JOHN (DC, FACO)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JOHN
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DC, FACO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1285 E PIDGEON RD
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OH
Mailing Address - Zip Code:44460-4364
Mailing Address - Country:US
Mailing Address - Phone:330-332-4307
Mailing Address - Fax:330-332-5757
Practice Address - Street 1:1285 E PIDGEON RD
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OH
Practice Address - Zip Code:44460-4364
Practice Address - Country:US
Practice Address - Phone:330-332-4307
Practice Address - Fax:330-332-5757
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-07
Last Update Date:2014-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3187111NX0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NX0800XChiropractic ProvidersChiropractorOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2267710Medicaid
OH9324671Medicare ID - Type Unspecified
OH2267710Medicaid