Provider Demographics
NPI:1740870716
Name:KNOTT, SCOTTIE JAMES (RPH)
Entity type:Individual
Prefix:
First Name:SCOTTIE
Middle Name:JAMES
Last Name:KNOTT
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:127 ACORN DR
Mailing Address - Street 2:
Mailing Address - City:SUNSET
Mailing Address - State:LA
Mailing Address - Zip Code:70584-6134
Mailing Address - Country:US
Mailing Address - Phone:337-662-5236
Mailing Address - Fax:337-662-3999
Practice Address - Street 1:127 ACORN DR
Practice Address - Street 2:
Practice Address - City:SUNSET
Practice Address - State:LA
Practice Address - Zip Code:70584-6134
Practice Address - Country:US
Practice Address - Phone:337-662-5236
Practice Address - Fax:337-662-3999
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-22
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA15279183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist