Broadnax, Scott

Broadnax, Scott is an sole proprietor health care provider with primary practice located at 8063 Madison Ave # 246 , Indianapolis IN 46227-6001. He recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as his primary health care specialty. Broadnax, Scott can be contacted via phone (317) 750-0435.

Contact Information

Primary practice address
8063 Madison Ave # 246 Indianapolis IN 46227-6001
Phone: (317) 750-0435
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Community Health Worker 172V00000X

Profile Details

NPI number 1053715284
LBN Legal business name Broadnax, Scott
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 17th, 2014
Last updated Oct 17th, 2014 - about 12 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 1053715284 NPPES
Indiana MEDICAID 201132640 A

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