Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | 32907 | SC |
N | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 32907 | NC |
NPI | 1366753535 |
---|---|
Provider Name | Kristi D Ford-Scales |
First Address | Atlanta, GA 30374-3070 |
Second Address | Spartanburg, SC 29303-3040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/06/2010 |
Last Update Date | 29/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
329077 | (05) | SC |
SC10746067 | MEDICARE PIN (01) | SC |
SC10746084 | MEDDICARE PIN (01) | SC |
SC1074J577 | MEDICARE PIN (01) | SC |