Provider Demographics
NPI:1063421428
Name:SCOTT, JOSEPH DANIEL (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:DANIEL
Last Name:SCOTT
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 1:997 W INTERSTATE 20
Mailing Address - Street 2:FAMILY MEDICAL ASSOCIATES
Mailing Address - City:COLORADO CITY
Mailing Address - State:TX
Mailing Address - Zip Code:79512-2685
Mailing Address - Country:US
Mailing Address - Phone:325-728-2693
Mailing Address - Fax:325-728-2420
Practice Address - Street 1:997 W INTERSTATE 20
Practice Address - Street 2:FAMILY MEDICAL ASSOCIATES
Practice Address - City:COLORADO CITY
Practice Address - State:TX
Practice Address - Zip Code:79512-2685
Practice Address - Country:US
Practice Address - Phone:325-728-2693
Practice Address - Fax:325-728-2420
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF1982207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX87T823OtherBLUE CROSS BLUE SHIELD
TX00PH53Medicare ID - Type Unspecified
TX87T823OtherBLUE CROSS BLUE SHIELD