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Individual

DR. SCOTT JOSEPH WAGUESPACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5960 OGEECHEE RD STE C, SAVANNAH, GA 31419-7506
(912) 349-2676
Mailing address
205 REES ST, AMERICUS, GA 31709-3756
(229) 928-4755
(229) 928-4750

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
063014
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003162142B
GA
01
102I084233
MEDICARE PTAN
GA
Enumeration date
07/16/2009
Last updated
09/29/2020
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