MEDICARE: YVONNE L SCOTT OB GYN

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	174400000X	Specialist	029945	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1831208032
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	YVONNE L SCOTT OB GYN

Provider Business Mailing Address
First Line	:	2200 FOUNTAIN DR
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-2919
Country	:	US
Telephone Number	:	770-682-9002
Fax Number	:	770-682-0504

Provider Business Practice Location Address
First Line	:	2200 FOUNTAIN DR
Second Line	:
City	:	SNELLVILLE
State	:	GA
Zip	:	30078-2919
Country	:	US
Telephone Number	:	770-682-9002
Fax Number	:	770-682-0504

Authorized Official
Title or Position	:	CEO
Name	:	YVONNE SCOTT-MILLER
Credential	:	M.D.
Telephone Number	:	770-682-9002

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	05/06/2020

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