Provider Demographics
NPI:1982767224
Name:SCOTT, THOMAS BROOKS (MD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BROOKS
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:367 S. GULPH RD
Mailing Address - Street 2:ATTN: IPM CREDENTIALING
Mailing Address - City:KING OF PRUSSIA
Mailing Address - State:PA
Mailing Address - Zip Code:19406-3121
Mailing Address - Country:US
Mailing Address - Phone:561-753-2680
Mailing Address - Fax:561-798-9249
Practice Address - Street 1:1397 MEDICAL PARK BLVD STE 180
Practice Address - Street 2:
Practice Address - City:WELLINGTON
Practice Address - State:FL
Practice Address - Zip Code:33414
Practice Address - Country:US
Practice Address - Phone:561-753-2680
Practice Address - Fax:561-798-9249
Is Sole Proprietor?:No
Enumeration Date:2006-12-18
Last Update Date:2018-06-11
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Provider Licenses
StateLicense IDTaxonomies
FLME92276208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLG48027Medicare UPIN