Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 057544 | GA |
N | 111NI0900X | Internist | 057544 | GA |
Y | 207RG0100X | Gastroenterologist | 02002647A | IN |
NPI | 1013082379 |
---|---|
Provider Name | Scott Thomas Mcnear |
First Address | Fort Gordon, GA 30905-5650 |
Second Address | Fort Gordon, GA 30905-5650 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 22/11/2006 |
Last Update Date | 15/05/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
VAD000 | (02) | TX |