Provider Demographics
NPI:1699297416
Name:SCOTT, ANDREW HUNTER (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:HUNTER
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 BEE ST APT A
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5881
Mailing Address - Country:US
Mailing Address - Phone:770-906-7762
Mailing Address - Fax:
Practice Address - Street 1:2500 N STATE ST
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216-4500
Practice Address - Country:US
Practice Address - Phone:601-984-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2022-05-09
Deactivation Date:2022-04-02
Deactivation Code:
Reactivation Date:2022-05-09
Provider Licenses
StateLicense IDTaxonomies
003980224P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist