Provider Demographics
NPI:1730385840
Name:SCOTT D BANKS DC PC
Entity type:Organization
Organization Name:SCOTT D BANKS DC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:D
Authorized Official - Last Name:BANKS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:757-331-1190
Mailing Address - Street 1:PO BOX 489
Mailing Address - Street 2:
Mailing Address - City:CAPE CHARLES
Mailing Address - State:VA
Mailing Address - Zip Code:23310-0489
Mailing Address - Country:US
Mailing Address - Phone:757-331-1190
Mailing Address - Fax:757-331-1260
Practice Address - Street 1:117 MASON AVE
Practice Address - Street 2:SUITE F
Practice Address - City:CAPE CHARLES
Practice Address - State:VA
Practice Address - Zip Code:23310-3121
Practice Address - Country:US
Practice Address - Phone:757-331-1190
Practice Address - Fax:757-331-1260
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAC08617Medicare ID - Type UnspecifiedMEDICARE GROUP #