Provider Demographics
NPI:1912260704
Name:SCHOLL, GEORGINA BATES
Entity Type:Individual
Prefix:DR
First Name:GEORGINA
Middle Name:BATES
Last Name:SCHOLL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 CROSS HWY
Mailing Address - Street 2:
Mailing Address - City:REDDING
Mailing Address - State:CT
Mailing Address - Zip Code:06896-2404
Mailing Address - Country:US
Mailing Address - Phone:203-938-4881
Mailing Address - Fax:
Practice Address - Street 1:60 CROSS HWY
Practice Address - Street 2:
Practice Address - City:REDDING
Practice Address - State:CT
Practice Address - Zip Code:06896-2404
Practice Address - Country:US
Practice Address - Phone:203-938-4881
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT049784207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology