Provider Demographics
NPI:1033196183
Name:AINSWORTH, SCOTT WELLS (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:WELLS
Last Name:AINSWORTH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 759
Mailing Address - Street 2:
Mailing Address - City:BLAIRSVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30514-0759
Mailing Address - Country:US
Mailing Address - Phone:706-745-8800
Mailing Address - Fax:706-745-8805
Practice Address - Street 1:35 HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:BLAIRSVILLE
Practice Address - State:GA
Practice Address - Zip Code:30512-3139
Practice Address - Country:US
Practice Address - Phone:706-745-8800
Practice Address - Fax:706-745-8805
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-29
Last Update Date:2014-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035799207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA005857OtherBLUE CROSS BLUE SHIELD
NC890633GMedicaid
GA122605OtherUNITED HEALTHCARE
GA376554453AMedicaid
GADB8101Medicare ID - Type UnspecifiedMEDICARE RAILROAD GROUP
GA376554453AMedicaid
GA122605OtherUNITED HEALTHCARE
NC890633GMedicaid
GA005857OtherBLUE CROSS BLUE SHIELD