Provider Demographics
NPI:1982868907
Name:SCOTT, JENNIFER UHL (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:UHL
Last Name:SCOTT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:122 4TH AVE STE 200
Mailing Address - Street 2:
Mailing Address - City:INDIALANTIC
Mailing Address - State:FL
Mailing Address - Zip Code:32903-3112
Mailing Address - Country:US
Mailing Address - Phone:321-327-3793
Mailing Address - Fax:321-327-7914
Practice Address - Street 1:122 4TH AVE STE 200
Practice Address - Street 2:
Practice Address - City:INDIALANTIC
Practice Address - State:FL
Practice Address - Zip Code:32903
Practice Address - Country:US
Practice Address - Phone:321-327-3793
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-18
Last Update Date:2019-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME937342084P0800X, 171W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry