Provider Demographics
NPI:1386701233
Name:SCOTT, CLARK GRAFTON (DC)
Entity type:Individual
Prefix:DR
First Name:CLARK
Middle Name:GRAFTON
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10535 GREENWAY DR
Mailing Address - Street 2:
Mailing Address - City:FISHERS
Mailing Address - State:IN
Mailing Address - Zip Code:46037-9374
Mailing Address - Country:US
Mailing Address - Phone:317-600-9480
Mailing Address - Fax:
Practice Address - Street 1:5750 E 91ST ST STE B
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-1380
Practice Address - Country:US
Practice Address - Phone:317-284-1329
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-02
Last Update Date:2021-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN08002298A111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor