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NPI Code Detail

MEDICARE: MR. SCOTT CURTIS BRENNAN PA

MEDICARE: MR. SCOTT CURTIS BRENNAN PA
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
1363A00000XPhysician Assistant000709GA

General Provider Information

NPI Number : 1700846763
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. SCOTT CURTIS BRENNAN PA
Provider Business Mailing Address
First Line : 2238 HILL PARK CT
Second Line :
City : DECATUR
State : GA
Zip : 30033-2716
Country : US
Telephone Number : 404-417-1773
Fax Number : 404-417-1770
Provider Business Practice Location Address
First Line : 582 CONCORD RD
Second Line : COBB VA CBOC
City : SMYRNA
State : GA
Zip : 30082-2616
Country : US
Telephone Number : 404-417-1773
Fax Number : 404-417-1770
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/24/2006
Last Update Date : 07/08/2007

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