Provider Demographics
NPI:1124035290
Name:GRIFFITH, SCOTT DEE (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:DEE
Last Name:GRIFFITH
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 1:120 KESWICK WAY
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-6315
Mailing Address - Country:US
Mailing Address - Phone:678-234-2332
Mailing Address - Fax:
Practice Address - Street 1:4310 JOHNS CREEK PKWY
Practice Address - Street 2:STE 100
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-6092
Practice Address - Country:US
Practice Address - Phone:678-234-2332
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2016-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA36386207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA0051828BMedicaid
E29119Medicare UPIN
GA0051828BMedicaid