Provider Demographics
NPI:1104898410
Name:PARSONS, SCOTT GARY (MD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:GARY
Last Name:PARSONS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3495 PIEDMONT RD NE
Mailing Address - Street 2:NINE PIEDMONT CENTER
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-1717
Mailing Address - Country:US
Mailing Address - Phone:404-364-7070
Mailing Address - Fax:803-765-9052
Practice Address - Street 1:1435 BROADMOOR BLVD
Practice Address - Street 2:KAISER PERMANENTE SUGAR HILL/BUFORD MEDICAL CENTER
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-5408
Practice Address - Country:US
Practice Address - Phone:678-765-5735
Practice Address - Fax:803-765-9052
Is Sole Proprietor?:No
Enumeration Date:2006-02-02
Last Update Date:2022-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC22997208000000X
GA068265208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCI15653Medicare UPIN