| Doctor Name: | VAN SCOTT MCCORKLE |
| NPI Number: | 1538157839 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 40734 |
| Business Practice Address: | 1520b Jennings Mill Rd Bogart, GA - 306222543 |
| Business Phone Number: | 7065481216 |
| Business Fax Number: | 7065481772 |
| Mailing Address: | 1520b Jennings Mill Rd, BOGART |
| State: | GA |
| Postal Code: | 306222543 |
| Phone Number: | 7065481216 |
| Fax Number: | 7065481772 |
| NPI Enumeration Date: | 10/11/2005 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2080A0000X |
| License Number: | 40734 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Pediatrics |
| Taxonomy Specialization: | Adolescent Medicine |
| Taxonomy Definition: | A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |