Provider Demographics
NPI:1700918034
Name:SCOTT, GEORGE C (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:C
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 N 7TH ST
Mailing Address - Street 2:SUITE 4205
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81501-8209
Mailing Address - Country:US
Mailing Address - Phone:970-298-7049
Mailing Address - Fax:970-298-2079
Practice Address - Street 1:2635 N 7TH ST
Practice Address - Street 2:SUITE 603
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81501
Practice Address - Country:US
Practice Address - Phone:970-298-7049
Practice Address - Fax:970-298-2079
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2018-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA95799207R00000X
CO46845207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO32054840Medicaid
COCO304148OtherMEDICARE PTAN