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NPI Code Detail

MEDICARE: DOMINIC JEREMY SCOTT

MEDICARE: DOMINIC JEREMY SCOTT
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
1390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1629969357
Entity Type Code : Individual
Provider Name (Legal Business Name) : DOMINIC JEREMY SCOTT
Provider Business Mailing Address
First Line : 3925 CAMDEN CT
Second Line :
City : GAINESVILLE
State : GA
Zip : 30506-2258
Country : US
Telephone Number : 678-316-3118
Fax Number :
Provider Business Practice Location Address
First Line : 500 WASHINGTON ST SE
Second Line :
City : GAINESVILLE
State : GA
Zip : 30501-3628
Country : US
Telephone Number : 770-534-6100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/11/2025
Last Update Date : 07/11/2025

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Directions to “ DOMINIC JEREMY SCOTT ” Practice Location

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