Provider Demographics
NPI:1023299138
Name:SCOTT, LORI COLLINS (MD)
Entity type:Individual
Prefix:
First Name:LORI
Middle Name:COLLINS
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:202 SUMMIT AVE
Mailing Address - Street 2:
Mailing Address - City:KINSTON
Mailing Address - State:NC
Mailing Address - Zip Code:28501-3956
Mailing Address - Country:US
Mailing Address - Phone:252-933-1325
Mailing Address - Fax:
Practice Address - Street 1:400 GLENWOOD AVE
Practice Address - Street 2:SUITE NUMBER 10
Practice Address - City:KINSTON
Practice Address - State:NC
Practice Address - Zip Code:28501-3851
Practice Address - Country:US
Practice Address - Phone:919-581-5882
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-16
Last Update Date:2011-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200701775207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine