MEDICARE: DR. JENNIE BAKER SCOGGINS 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	208000000X	Pediatrics Physician	67792	GA

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
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1982727400
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JENNIE BAKER SCOGGINS M.D.

Provider Business Mailing Address
First Line	:	550 PROFESSIONAL DR
Second Line	:
City	:	MACON
State	:	GA
Zip	:	31201-1411
Country	:	US
Telephone Number	:	478-741-3007
Fax Number	:

Provider Business Practice Location Address
First Line	:	411 TOWN PARK BLVD
Second Line	:
City	:	EVANS
State	:	GA
Zip	:	30809-3487
Country	:	US
Telephone Number	:	706-854-2500
Fax Number	:	706-854-2559

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

Provider Enumeration Date	:	04/09/2007
Last Update Date	:	10/27/2025

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