Provider Demographics
NPI:1063429546
Name:SCOTT, JOYCE ELAINE (DO)
Entity type:Individual
Prefix:DR
First Name:JOYCE
Middle Name:ELAINE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1456 PROCTOR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:CELINA
Mailing Address - State:TN
Mailing Address - Zip Code:38551-6144
Mailing Address - Country:US
Mailing Address - Phone:931-243-4312
Mailing Address - Fax:931-243-4311
Practice Address - Street 1:1456 PROCTOR CREEK RD
Practice Address - Street 2:
Practice Address - City:CELINA
Practice Address - State:TN
Practice Address - Zip Code:38551-6144
Practice Address - Country:US
Practice Address - Phone:931-243-4312
Practice Address - Fax:931-243-4311
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2009-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO 1091207QG0300X
TNDO1091207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3284803Medicaid
TN3091574OtherBCBSTN
TNG10130Medicare UPIN
TN3304125Medicare PIN