MEDICARE: DR. SCOTT WILLIS MCCORMICK DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	CHIR011408	GA

General Provider Information

NPI Number	:	1467566570
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SCOTT WILLIS MCCORMICK DC

Provider Business Mailing Address
First Line	:	900 GULF BLVD APT 202
Second Line	:
City	:	INDIAN ROCKS BEACH
State	:	FL
Zip	:	33785-2726
Country	:	US
Telephone Number	:	215-694-4831
Fax Number	:

Provider Business Practice Location Address
First Line	:	3901 MARY ELIZA TRCE NW STE 201
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30064-1096
Country	:	US
Telephone Number	:	215-694-4831
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/18/2006
Last Update Date	:	03/30/2026

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