Provider Demographics
NPI:1972605301
Name:SCHOLL, ELIZABETH K (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:ELIZABETH
Middle Name:K
Last Name:SCHOLL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:100 PROFESSIONAL PL
Mailing Address - Street 2:SUITE 204
Mailing Address - City:CARROLLTON
Mailing Address - State:GA
Mailing Address - Zip Code:30117-3874
Mailing Address - Country:US
Mailing Address - Phone:770-834-3351
Mailing Address - Fax:770-830-1518
Practice Address - Street 1:100 PROFESSIONAL PL
Practice Address - Street 2:SUITE 204
Practice Address - City:CARROLLTON
Practice Address - State:GA
Practice Address - Zip Code:30117-3874
Practice Address - Country:US
Practice Address - Phone:770-834-3351
Practice Address - Fax:770-830-1518
Is Sole Proprietor?:No
Enumeration Date:2006-09-05
Last Update Date:2016-05-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA003075363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA970029174OtherRAIL ROAD MEDICARE
GA100002343AMedicaid
GA100002343AMedicaid
GA97WCCWBMedicare PIN