Provider Demographics
NPI:1942240437
Name:SCOTT, EDWIN HUGHES (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:HUGHES
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2510
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-2510
Mailing Address - Country:US
Mailing Address - Phone:706-922-8251
Mailing Address - Fax:706-922-6695
Practice Address - Street 1:2011 WINDSOR SPRING RD
Practice Address - Street 2:
Practice Address - City:AUGUSTA
Practice Address - State:GA
Practice Address - Zip Code:30906-4957
Practice Address - Country:US
Practice Address - Phone:706-798-1700
Practice Address - Fax:706-798-8626
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035753207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA10056602OtherAMERIGROUP
GA00511431BMedicaid
GA338156OtherWELLCARE
GACH0654OtherRR MEDICARE GROUP PIN
SCG35753Medicaid
GA00511431BMedicaid
GA338156OtherWELLCARE