Provider Demographics
NPI:1023139565
Name:SCOTT, MARIA C
Entity type:Individual
Prefix:MRS
First Name:MARIA
Middle Name:C
Last Name:SCOTT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9429 SE 29TH ST
Mailing Address - Street 2:LOT 114
Mailing Address - City:MIDWEST CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73130-7205
Mailing Address - Country:US
Mailing Address - Phone:405-737-3299
Mailing Address - Fax:
Practice Address - Street 1:9429 SE 29TH ST
Practice Address - Street 2:LOT 114
Practice Address - City:MIDWEST CITY
Practice Address - State:OK
Practice Address - Zip Code:73130-7205
Practice Address - Country:US
Practice Address - Phone:405-737-3299
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor