Provider Demographics
NPI:1699793299
Name:SCOTT, GEORGE PHILIP (DO)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:PHILIP
Last Name:SCOTT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:G.
Other - Middle Name:PHILIP
Other - Last Name:SCOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:933 COLUMBIA AVENUE
Mailing Address - Street 2:UNIT C5
Mailing Address - City:CAPE MAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08204-1682
Mailing Address - Country:US
Mailing Address - Phone:717-880-1785
Mailing Address - Fax:717-751-6012
Practice Address - Street 1:933 COLUMBIA AVENUE
Practice Address - Street 2:UNIT C5
Practice Address - City:CAPE MAY
Practice Address - State:NJ
Practice Address - Zip Code:08204-1682
Practice Address - Country:US
Practice Address - Phone:717-880-1785
Practice Address - Fax:717-751-6012
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2015-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS003349L208600000X
NJ25MB03053000208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006778400003Medicaid
PA161438DX5Medicare PIN
PA020037949Medicare PIN
PA0006778400003Medicaid