Gardner, Scott Allan

Gardner, Scott Allan is an individual health care provider with primary practice located at 2315 8Th St , Lewiston ID 83501-7301. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Gardner, Scott Allan can be contacted via phone (208) 298-9030.

Contact Information

Primary practice address
2315 8Th St Lewiston ID 83501-7301
Phone: (208) 298-9030
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X MD16480 Oregon
Allopathic & Osteopathic Physicians / Surgery 208600000X M9619 Idaho
Allopathic & Osteopathic Physicians / Surgery 208600000X MD00046059 Washington

Profile Details

NPI number 1568458701
LBN Legal business name Gardner, Scott Allan
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2005
Last updated Oct 30th, 2012 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1568458701 NPPES
Oregon MEDICAID 012554
Oregon Other 0212253
Oregon MEDICAID 1013432
Oregon Other 1568458701
Oregon Other 1134119
Oregon Other 76714
Oregon Other P00815199
Oregon MEDICAID 1568458701
Oregon Other P00349485

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