Individual
DR. SCOT A WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2304 ROSEMONT CT, ALBANY, GA 31721-9110
(229) 888-5023
Mailing address
2304 ROSEMONT CT, ALBANY, GA 31721-9110
(229) 888-5023
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
14675
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00136529A
—
GA
Enumeration date
06/21/2005
Last updated
04/12/2017
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