Provider Demographics
NPI:1013924521
Name:SCOTT, DALE EDWARD JR (DC)
Entity Type:Individual
Prefix:
First Name:DALE
Middle Name:EDWARD
Last Name:SCOTT
Suffix:JR
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 1:7940 PARALLEL PKWY
Mailing Address - Street 2:#3
Mailing Address - City:KANSAS CITY
Mailing Address - State:KS
Mailing Address - Zip Code:66112-2050
Mailing Address - Country:US
Mailing Address - Phone:913-299-8090
Mailing Address - Fax:913-299-8064
Practice Address - Street 1:7940 PARALLEL PKWY
Practice Address - Street 2:#3
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112
Practice Address - Country:US
Practice Address - Phone:913-299-8090
Practice Address - Fax:913-299-8064
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0103727111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
R075281Medicare ID - Type Unspecified
T42340Medicare UPIN