Provider Demographics
NPI:1922249267
Name:RAPPE, SCOTT (DO)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:RAPPE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:190 GREENCASTLE RD
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-2936
Mailing Address - Country:US
Mailing Address - Phone:770-487-7807
Mailing Address - Fax:770-487-7619
Practice Address - Street 1:190 GREENCASTLE RD
Practice Address - Street 2:
Practice Address - City:TYRONE
Practice Address - State:GA
Practice Address - Zip Code:30290-2936
Practice Address - Country:US
Practice Address - Phone:770-487-7807
Practice Address - Fax:770-487-7619
Is Sole Proprietor?:No
Enumeration Date:2009-03-17
Last Update Date:2016-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA73367207R00000X
NY261688207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYG400068474OtherMEDICARE-QUEENS
A400064980Medicare PIN