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General NPI Number Information
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NPI Number | 1225259443
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Entity Type | Organization
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Legal Business Name | GEORGIA COASTAL THORACIC, PC
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Dates
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Enumeration Date | 05/02/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2500 STARLING ST SUITE 501
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City | BRUNSWICK
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State | GA
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Zip | 31520-4219
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Country | US
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Telephone | 912-262-9998
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Fax |
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Provider Business Mailing Address
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Address Line | 2500 STARLING ST SUITE 501
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City | BRUNSWICK
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State | GA
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Zip | 31520-4219
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Country | US
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Telephone | 912-262-9998
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. WALTER W SCOTT
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Credential | MD
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Telephone | 912-262-9998
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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