Keith, Randall Scott

Keith, Randall Scott is an sole proprietor health care provider with primary practice located at 104 Ararat Longhill Rd , Pilot Mountain NC 27041-8113. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Keith, Randall Scott can be contacted via phone (336) 786-7966.

Contact Information

Primary practice address
104 Ararat Longhill Rd Pilot Mountain NC 27041-8113
Phone: (336) 786-7966
Fax: (336) 786-1601
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 39630 North Carolina

Profile Details

NPI number 1477558542
LBN Legal business name Keith, Randall Scott
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 16th, 2005
Last updated Jun 14th, 2012 - about 14 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 1477558542 NPPES
North Carolina MEDICAID 8948063
North Carolina Other 3966
North Carolina Other BCBS OF NC

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