MEDICARE: DR. SCOTT CHRISTOPHER MITCHELL M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	056212	GA
2	207Q00000X	Family Medicine Physician	200101250	NC

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	511I080261	OTHER	GA	MEDICARE PIN PCN
5	511I080260	OTHER	GA	MEDICARE PIN QUICK CARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	056212	OTHER	GA	GEORGIA LICENSE

General Provider Information

NPI Number	:	1417963026
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT CHRISTOPHER MITCHELL M.D.

Provider Business Mailing Address
First Line	:	799 HAMMOND DR NE
Second Line	:	UNIT 329
City	:	ATLANTA
State	:	GA
Zip	:	30328-7169
Country	:	US
Telephone Number	:	404-783-9384
Fax Number	:

Provider Business Practice Location Address
First Line	:	60 MILLENNIUM CIR
Second Line	:
City	:	RINGGOLD
State	:	GA
Zip	:	30736-2775
Country	:	US
Telephone Number	:	706-937-2099
Fax Number	:	706-937-4062

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/01/2006
Last Update Date	:	05/13/2009

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Directions to “ DR. SCOTT CHRISTOPHER MITCHELL M.D.” Practice Location

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