Basic Information
| Provider Information | |||||||||
| NPI: | 1003811886 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHOLL | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | J | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 531 ROSELANE ST NW STE 710 | ||||||||
| Address2: | |||||||||
| City: | MARIETTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300606975 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6783313297 | ||||||||
| FaxNumber: | 6785817187 | ||||||||
| Practice Location | |||||||||
| Address1: | 157 CLINIC AVE STE 101 | ||||||||
| Address2: | |||||||||
| City: | CARROLLTON | ||||||||
| State: | GA | ||||||||
| PostalCode: | 301174454 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7703332220 | ||||||||
| FaxNumber: | 6785817180 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/17/2005 | ||||||||
| LastUpdateDate: | 01/08/2018 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363AM0700X | 003286 | GA | Y | Physician Assistants & Advanced Practice Nursing Providers | Physician Assistant | Medical |
ID Information
| ID | Type | State | Issuer | Description | 100001986C | 05 | GA | MEDICAID | 1003811886 | 01 | GA | NPI NUMBER | OTHER | 891003510 | 05 | AL | MEDICAID | 100001986B | 05 | GA | MEDICAID | 100001986A | 05 | GA | MEDICAID |