Individual
DR. DEREK S SCOTT I
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2101 NEWNAN CROSSING BLVD E, NEWNAN, GA 30265
(678) 552-6294
Mailing address
980 BIRMINGHAM RD STE 501-403, MILTON, GA 30004-4417
(678) 552-6294
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
077308
GA
208100000X
Physical Medicine & Rehabilitation Physician
4301085359
MI
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
4301085359
MI
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
4301085359
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
018888888
—
MI
01
—
43085359
BLUECROSS
MI
Enumeration date
10/06/2006
Last updated
06/10/2021
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