Provider Demographics
NPI:1912012915
Name:BURNS, DONALD SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:SCOTT
Last Name:BURNS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:DONALD
Other - Middle Name:SCOTT
Other - Last Name:BURNS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1348 WALTON WAY
Mailing Address - Street 2:SUITE 4100
Mailing Address - City:AUGUSTA
Mailing Address - State:GA
Mailing Address - Zip Code:30901-5107
Mailing Address - Country:US
Mailing Address - Phone:706-722-1381
Mailing Address - Fax:706-823-6871
Practice Address - Street 1:1348 WALTON WAY
Practice Address - Street 2:STE 4100
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30901-5107
Practice Address - Country:US
Practice Address - Phone:706-722-1381
Practice Address - Fax:706-823-6871
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052335207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA013243114AMedicaid
1988OtherGRP MCARE
1988OtherGRP MCARE
GA013243114AMedicaid