Healthcare Provider Details

I. General information

NPI: 1457349367
Provider Name (Legal Business Name): SCOTT MARC KARLIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2005
Last Update Date: 12/18/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4385 JOHNS CREEK PKWY SUITE 250
SUWANEE GA
30024-6048
US

IV. Provider business mailing address

4385 JOHNS CREEK PKWY SUITE 250
SUWANEE GA
30024-6048
US

V. Phone/Fax

Practice location:
  • Phone: 770-623-1608
  • Fax: 678-992-2540
Mailing address:
  • Phone: 770-939-9614
  • Fax: 678-992-2540

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number031775
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number031775
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207YX0602X
TaxonomyOtolaryngic Allergy Physician
License Number031775
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: