Individual
SCOTT MIKELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
658 NORTHSIDE DR E STE A, STATESBORO, GA 30458-4828
(912) 764-9684
Mailing address
PO BOX 689022, FRANKLIN, TN 37068-9022
(615) 465-7211
(912) 489-3676
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2017-01778
NC
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
1031577657
GA
Other
Enumeration date
05/23/2014
Last updated
01/11/2023
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