Provider Demographics
NPI:1982949970
Name:SCOTT, MORGAN DOREEN (PA-C)
Entity Type:Individual
Prefix:
First Name:MORGAN
Middle Name:DOREEN
Last Name:SCOTT
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:801 YORK STREET
Mailing Address - Street 2:
Mailing Address - City:MANITOWOC
Mailing Address - State:WI
Mailing Address - Zip Code:54220-4630
Mailing Address - Country:US
Mailing Address - Phone:920-663-9035
Mailing Address - Fax:920-663-0370
Practice Address - Street 1:8505 ARLINGTON BLVD
Practice Address - Street 2:SUITE 210
Practice Address - City:FAIRFAX
Practice Address - State:VA
Practice Address - Zip Code:22031-4621
Practice Address - Country:US
Practice Address - Phone:703-846-0076
Practice Address - Fax:703-846-0025
Is Sole Proprietor?:No
Enumeration Date:2012-12-03
Last Update Date:2017-09-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
VA0110004032363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical