Provider Demographics
NPI:1801598198
Name:TINGEY, SCOTT BURTON (DO)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:BURTON
Last Name:TINGEY
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:395 W COUGAR BLVD STE 205
Mailing Address - Street 2:
Mailing Address - City:PROVO
Mailing Address - State:UT
Mailing Address - Zip Code:84604-3328
Mailing Address - Country:US
Mailing Address - Phone:801-357-1770
Mailing Address - Fax:801-357-1779
Practice Address - Street 1:395 W COUGAR BLVD STE 205
Practice Address - Street 2:
Practice Address - City:PROVO
Practice Address - State:UT
Practice Address - Zip Code:84604-3328
Practice Address - Country:US
Practice Address - Phone:801-357-1770
Practice Address - Fax:801-357-1779
Is Sole Proprietor?:No
Enumeration Date:2023-03-20
Last Update Date:2025-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT14151455-1204207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine