Provider Demographics
NPI:1194168484
Name:SCOTT S PRINCE, DO, LLC
Entity type:Organization
Organization Name:SCOTT S PRINCE, DO, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:STEVEN
Authorized Official - Last Name:PRINCE
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:570-822-8875
Mailing Address - Street 1:101 W END RD
Mailing Address - Street 2:
Mailing Address - City:HANOVER TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:18706-5448
Mailing Address - Country:US
Mailing Address - Phone:570-822-8875
Mailing Address - Fax:570-822-8873
Practice Address - Street 1:101 W END RD
Practice Address - Street 2:
Practice Address - City:HANOVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:18706-5448
Practice Address - Country:US
Practice Address - Phone:570-822-8875
Practice Address - Fax:570-822-8873
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-17
Last Update Date:2013-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007533L261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care