Provider Demographics
NPI:1720266307
Name:SCOTT, CHRISTOPHER CULLEN (MD)
Entity Type:Individual
Prefix:DR
First Name:CHRISTOPHER
Middle Name:CULLEN
Last Name:SCOTT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1240 JESSE JEWELL PARKWAY SE
Mailing Address - Street 2:SUITE 300
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30501-3861
Mailing Address - Country:US
Mailing Address - Phone:770-534-7200
Mailing Address - Fax:
Practice Address - Street 1:1240 JESSE JEWELL PARKWAY SE
Practice Address - Street 2:SUITE 300
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30501-3861
Practice Address - Country:US
Practice Address - Phone:770-534-7200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-05
Last Update Date:2016-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA057015207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA333690169BMedicaid