Healthcare Provider Details

I. General information

NPI: 1962664086
Provider Name (Legal Business Name): JOHN SOCRATES SCALES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/30/2008
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

743 SPRING ST NE
GAINESVILLE GA
30501-3715
US

IV. Provider business mailing address

1490 SE MAGNOLIA EXT
OCALA FL
34471-4443
US

V. Phone/Fax

Practice location:
  • Phone: 770-219-8420
  • Fax:
Mailing address:
  • Phone: 352-671-4221
  • Fax: 352-671-4393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberME 116000
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberME116000
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number67766
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: