Provider Demographics
NPI:1659650810
Name:CORRECTMED SCOTT, LLC
Entity Type:Organization
Organization Name:CORRECTMED SCOTT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:MISS
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FAULKNER
Authorized Official - Suffix:
Authorized Official - Credentials:FNP
Authorized Official - Phone:770-626-5740
Mailing Address - Street 1:PO BOX 538491
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30353-8491
Mailing Address - Country:US
Mailing Address - Phone:770-626-4760
Mailing Address - Fax:770-626-4765
Practice Address - Street 1:4861 BILL GARDNER PKWY
Practice Address - Street 2:STE 100
Practice Address - City:LOCUST GROVE
Practice Address - State:GA
Practice Address - Zip Code:30248-3644
Practice Address - Country:US
Practice Address - Phone:770-626-5580
Practice Address - Fax:770-626-5585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-08-05
Last Update Date:2013-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty