| Doctor Name: | DR. CHARLES C SCOTT |
| NPI Number: | 1871635730 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 28379 |
| Business Practice Address: | 1905 W 19th St Mountain Grove, MO - 657111287 |
| Business Phone Number: | 4179261770 |
| Business Fax Number: | 4179261785 |
| Mailing Address: | 1905 W 19th St, MOUNTAIN GROVE |
| State: | MO |
| Postal Code: | 657111287 |
| Phone Number: | 4179261770 |
| Fax Number: | 4179261785 |
| NPI Enumeration Date: | 02/13/2007 |
| NPI Last Update Date: | 12/22/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 28379 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MO |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |