Provider Demographics
NPI:1598823262
Name:STARRETT, JAMES SCOTT (DC)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:SCOTT
Last Name:STARRETT
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 MARIETTA HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:CANTON
Mailing Address - State:GA
Mailing Address - Zip Code:30114-8212
Mailing Address - Country:US
Mailing Address - Phone:770-720-4626
Mailing Address - Fax:770-720-4626
Practice Address - Street 1:2920 MARIETTA HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:CANTON
Practice Address - State:GA
Practice Address - Zip Code:30114-8212
Practice Address - Country:US
Practice Address - Phone:770-720-4626
Practice Address - Fax:770-720-4626
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA6277111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA35ZCFSGMedicare ID - Type Unspecified
GAU77629Medicare UPIN