Provider Demographics
NPI:1154308500
Name:SCOTT, JOHN STUART (DO)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:STUART
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3820 NORTHDALE BLVD STE 201
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33624-1893
Mailing Address - Country:US
Mailing Address - Phone:800-991-6117
Mailing Address - Fax:888-812-8191
Practice Address - Street 1:3310 LIVE OAK ST STE 410
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75204-6145
Practice Address - Country:US
Practice Address - Phone:800-991-6117
Practice Address - Fax:812-812-8191
Is Sole Proprietor?:No
Enumeration Date:2005-12-28
Last Update Date:2025-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXG9889207L00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX135751915Medicaid
TX135751901Medicaid
TX8EH348OtherBCBS
TXP01358434OtherRR
TX135751901Medicaid
TX339227YK6UMedicare PIN
TX89477KMedicare PIN
A67627Medicare UPIN
TX135751908Medicaid
TX135751910Medicaid
TXTXB106600Medicare PIN
TX135751913OtherMEDICAID CSHCN
TX135751901Medicaid
TX135781914OtherMEDICAID CSHCN
TX85094KOtherBCBS
TX135751911Medicaid