Healthcare Provider Details

I. General information

NPI: 1124068101
Provider Name (Legal Business Name): PETER H SCOTT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: PETER HILL SCOTT MD

II. Dates (important events)

Enumeration Date: 06/07/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 LAKE HEARN DR STE 450
ATLANTA GA
30342
US

IV. Provider business mailing address

1100 LAKE HEARN DR STE 450
ATLANTA GA
30342
US

V. Phone/Fax

Practice location:
  • Phone: 404-252-7339
  • Fax: 404-257-0337
Mailing address:
  • Phone: 404-252-7339
  • Fax: 404-257-0337

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0214X
TaxonomyPediatric Pulmonology Physician
License Number029374
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: