Provider Demographics
NPI:1316949209
Name:HANDLEY, SCOTT A (DPM)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:HANDLEY
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 DEEP MEADOW LN
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-2068
Mailing Address - Country:US
Mailing Address - Phone:941-730-3261
Mailing Address - Fax:
Practice Address - Street 1:694 MAIN ST
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-3540
Practice Address - Country:US
Practice Address - Phone:401-884-2821
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-11
Last Update Date:2022-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDPM00353213ES0103X
FLPO3023213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL480034525OtherRR INDIVIDUAL PROV. #
FL65768ZMedicare PIN
U91636Medicare UPIN