Provider Demographics
NPI:1154317386
Name:VANN, SCOTT W (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:W
Last Name:VANN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:7208 HODGSON MEMORIAL DRIVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-2512
Mailing Address - Country:US
Mailing Address - Phone:912-351-5050
Mailing Address - Fax:912-351-5051
Practice Address - Street 1:7208 HODGSON MEMORIAL DRIVE
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2512
Practice Address - Country:US
Practice Address - Phone:912-351-5050
Practice Address - Fax:912-351-5051
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-22
Last Update Date:2010-12-27
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA19802208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00227136CMedicaid
D41280Medicare UPIN