Provider Demographics
NPI:1578832895
Name:SCOTT T. CUMMINS, P.C.
Entity Type:Organization
Organization Name:SCOTT T. CUMMINS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:THOMAS
Authorized Official - Last Name:CUMMINS
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:706-865-2166
Mailing Address - Street 1:PO BOX 687
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:GA
Mailing Address - Zip Code:30528-0012
Mailing Address - Country:US
Mailing Address - Phone:706-865-2166
Mailing Address - Fax:706-865-2154
Practice Address - Street 1:550 HELEN HWY
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:GA
Practice Address - Zip Code:30528-1049
Practice Address - Country:US
Practice Address - Phone:706-865-2166
Practice Address - Fax:706-865-2154
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-14
Last Update Date:2011-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIRO002882111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
U31710Medicare UPIN
35ZCDPQMedicare PIN