Provider Demographics
NPI:1255404869
Name:SCARBOROUGH, LONNIE T (MD)
Entity type:Individual
Prefix:DR
First Name:LONNIE
Middle Name:T
Last Name:SCARBOROUGH
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 1:315 COMMERCIAL DR
Mailing Address - Street 2:STE 3
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3631
Mailing Address - Country:US
Mailing Address - Phone:912-352-9902
Mailing Address - Fax:912-352-9960
Practice Address - Street 1:315 COMMERCIAL DR
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3628
Practice Address - Country:US
Practice Address - Phone:912-352-9902
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2016-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA022469174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist