Provider Demographics
NPI:1174956262
Name:SCOTT COUNTY HEALTH DEPARTMENT
Entity type:Organization
Organization Name:SCOTT COUNTY HEALTH DEPARTMENT
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PUBLIC HEALTH OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:KEVIN
Authorized Official - Last Name:ROGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:812-752-4656
Mailing Address - Street 1:1471 N GARDNER ST
Mailing Address - Street 2:
Mailing Address - City:SCOTTSBURG
Mailing Address - State:IN
Mailing Address - Zip Code:47170-7751
Mailing Address - Country:US
Mailing Address - Phone:812-752-8455
Mailing Address - Fax:812-752-6023
Practice Address - Street 1:1471 N GARDNER ST
Practice Address - Street 2:
Practice Address - City:SCOTTSBURG
Practice Address - State:IN
Practice Address - Zip Code:47170-7751
Practice Address - Country:US
Practice Address - Phone:812-752-8455
Practice Address - Fax:812-752-6023
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-13
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01035467A251K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251K00000XAgenciesPublic Health or Welfare