Provider Demographics
NPI:1881620193
Name:KITCHEL, SCOTT H (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:H
Last Name:KITCHEL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74B CENTENNIAL LOOP
Mailing Address - Street 2:SUITE 100
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-7918
Mailing Address - Country:US
Mailing Address - Phone:541-393-0100
Mailing Address - Fax:541-393-0104
Practice Address - Street 1:74B CENTENNIAL LOOP
Practice Address - Street 2:SUITE 100
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-7918
Practice Address - Country:US
Practice Address - Phone:541-393-0100
Practice Address - Fax:541-393-0104
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD14956207XS0117X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0117XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Surgery of the Spine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR147629Medicaid
R135636Medicare PIN
D72895Medicare UPIN