Provider Demographics
NPI:1871597237
Name:BENTSON, SCOTT ANDREW (DC)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANDREW
Last Name:BENTSON
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 1:5602 E 5TH ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85711-2449
Mailing Address - Country:US
Mailing Address - Phone:520-747-2724
Mailing Address - Fax:520-747-5845
Practice Address - Street 1:5602 E 5TH ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85711-2449
Practice Address - Country:US
Practice Address - Phone:520-747-2724
Practice Address - Fax:520-747-5845
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ3764111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1Z3244OtherHEALTHNET
AZSB1010990OtherASHN
AZAZ0081720OtherBLUE CROSS BLUE SHIELD