1750506978 NPI number — SCOTT CLIFFORD MCINTURFF P.T., D.P.T., A.T.C.

NPI Number: 1750506978
Health Care Provider/Practitioner: SCOTT CLIFFORD MCINTURFF P.T., D.P.T., A.T.C.

NPI Number : 1750506978 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1750506978",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MCINTURFF",
    "FirstName": "SCOTT",
    "MiddleName": "CLIFFORD",
    "NamePrefix": "MR.",
    "NameSuffix": null,
    "Credential": "P.T., D.P.T., A.T.C.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "1955 LAKESHORE OVERLOOK CIR NW",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "KENNESAW",
    "MailingAddressStateName": "GA",
    "MailingAddressPostalCode": "30152-6711",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "770-597-6590",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "2220 WISTERIA DR",
    "SecondLinePracticeLocationAddress": "SUITE 204",
    "PracticeLocationAddressCityName": "SNELLVILLE",
    "PracticeLocationAddressStateName": "GA",
    "PracticeLocationAddressPostalCode": "30078-2656",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "404-785-8081",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "04/14/2007",
    "LastUpdateDate": "09/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "225100000X",
          "TaxonomyName": "Physical Therapist",
          "LicenseNumber": "PT007579",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "2255A2300X",
          "TaxonomyName": "Athletic Trainer",
          "LicenseNumber": "AT001319",
          "LicenseNumberStateCode": "GA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}