Provider Demographics
NPI:1174557433
Name:NORRIS, SCOTT MCGILL (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:MCGILL
Last Name:NORRIS
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 1:11551 S FORTUNA RD
Mailing Address - Street 2:STE. B
Mailing Address - City:YUMA
Mailing Address - State:AZ
Mailing Address - Zip Code:85367-7853
Mailing Address - Country:US
Mailing Address - Phone:928-342-7220
Mailing Address - Fax:928-342-7223
Practice Address - Street 1:11551 S FORTUNA RD
Practice Address - Street 2:STE. B
Practice Address - City:YUMA
Practice Address - State:AZ
Practice Address - Zip Code:85367-7853
Practice Address - Country:US
Practice Address - Phone:928-342-7220
Practice Address - Fax:928-342-7223
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ6040111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZP00089483OtherRAILROAD MEDICARE
AZ802894Medicaid
AZT06487Medicare UPIN
AZ802894Medicaid