Provider Demographics
NPI:1104254549
Name:SCHAUSS, SCOTT (PA-C)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:
Last Name:SCHAUSS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5178 W BURNTSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84009-6125
Mailing Address - Country:US
Mailing Address - Phone:812-760-7217
Mailing Address - Fax:
Practice Address - Street 1:3723 W. 12600 S. SUITE 480
Practice Address - Street 2:RIVERTON SLEEP DISORDERS CENTER
Practice Address - City:RIVERTON
Practice Address - State:UT
Practice Address - Zip Code:84605
Practice Address - Country:US
Practice Address - Phone:801-285-4870
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-22
Last Update Date:2016-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT9032330463363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical