Individual
DARRELL KEVIN SCALES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1404 RIVER PL STE 401, BRASELTON, GA 30517-5600
(770) 848-6190
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
054937
GA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
054937
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
885647467A
—
GA
Enumeration date
05/04/2006
Last updated
10/15/2020
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