Provider Demographics
NPI:1770303281
Name:MINER, SCOTT JEFFREY
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:JEFFREY
Last Name:MINER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1028 N WARREN ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-3453
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:310 S SANSOME ST
Practice Address - Street 2:
Practice Address - City:PHILIPSBURG
Practice Address - State:MT
Practice Address - Zip Code:59858-7711
Practice Address - Country:US
Practice Address - Phone:406-859-3271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-10
Last Update Date:2024-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant