Provider Demographics
NPI:1871558163
Name:FORRER, SCOTT C (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:C
Last Name:FORRER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Mailing Address - Street 1:800 N SWAN RD STE 104
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-1256
Mailing Address - Country:US
Mailing Address - Phone:520-721-1000
Mailing Address - Fax:520-318-4766
Practice Address - Street 1:800 N SWAN RD STE 104
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-1256
Practice Address - Country:US
Practice Address - Phone:520-721-1000
Practice Address - Fax:520-318-4766
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2021-06-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ192962084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZMD19296Medicare PIN