Scott, Jerald R

Scott, Jerald R is an individual health care provider with primary practice located at 91-3633 Kauluakoko Unit 406 , Ewa Beach HI 96706-5867. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Hematology, Allopathic & Osteopathic Physicians / Family Medicine. Allopathic & Osteopathic Physicians / Family Medicine is his primary health care specialty. Scott, Jerald R can be contacted via phone (907) 775-6780.

Contact Information

Primary practice address
91-3633 Kauluakoko Unit 406 Ewa Beach HI 96706-5867
Phone: (907) 775-6780
Fax: (808) 312-4582
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Hematology 207ZH0000X 4721 Alaska
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MD-15012 Hawaii

Profile Details

NPI number 1902872625
LBN Legal business name Scott, Jerald R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 23rd, 2006
Last updated Apr 14th, 2021 - about 4 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 1902872625 NPPES
Alaska MEDICAID MD47212

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