Provider Demographics
NPI:1801093224
Name:BOSWELL, SCOTT MICHAEL (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MICHAEL
Last Name:BOSWELL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 S. SANTA FE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401
Mailing Address - Country:US
Mailing Address - Phone:785-823-1032
Mailing Address - Fax:785-452-7807
Practice Address - Street 1:501 S. SANTA FE
Practice Address - Street 2:SUITE 300
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401
Practice Address - Country:US
Practice Address - Phone:785-823-1032
Practice Address - Fax:785-452-7807
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2020-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS0436317207T00000X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS201071110AMedicaid
KS110116091Medicare PIN