Scott Wesley Anderson, MA, LAT, ATC
Individual provider Active NPI Athletic Trainer · Marion, IN
NPI 1447775432 · NPPES record last updated Aug 10, 2017
Key facts
- NPI
- 1447775432
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Athletic Trainer 2255A2300X
- License
- 36002684A (IN)
- Practice address
- 4201 S Washington St
Marion, IN 46953-4974 - Phone
- (765) 677-3335
- NPI assigned
- Aug 10, 2017
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 36002684A | IN | MD | Athletic Trainer |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 36002684A | IN | Yes |
Addresses
Primary practice location
4201 S Washington St
Marion, IN 46953-4974
Mailing address
1503 N Wabash Ave
Marion, IN 46952-1801
Phone (805) 729-4268
Other providers in Marion, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 10, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.