Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223X0400X | Orthodontists | 11102 | GA |
NPI | 1053331017 |
---|---|
Provider Name | Dr. Scott T. Mcpherson |
First Address | Peachtree City, GA 30269-6851 |
Second Address | Peachtree City, GA 30269-6851 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 20/07/2006 |
Last Update Date | 08/07/2007 |