Provider Demographics
NPI:1891868618
Name:ROYSON, SCOTT M (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:ROYSON
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 1:950 ATLANTIC CITY BLVD RT 9
Mailing Address - Street 2:SUITE 5
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-3564
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:950 ATLANTIC CITY BLVD RT 9
Practice Address - Street 2:SUITE 5
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-3564
Practice Address - Country:US
Practice Address - Phone:732-237-0677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMC 04590111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJU71443Medicare UPIN
NJ013090Medicare ID - Type UnspecifiedPROVIDER ID