Individual
VAN SCOTT MCCORKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1520B JENNINGS MILL RD, BOGART, GA 30622-2543
(706) 548-1216
(706) 548-1772
Mailing address
1520B JENNINGS MILL RD, BOGART, GA 30622-2543
(706) 548-1216
(706) 548-1772
Taxonomy
Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
40734
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00757094C
—
GA
Enumeration date
10/11/2005
Last updated
07/09/2007
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