Provider Demographics
NPI:1366545329
Name:SCANLON, JAMI BETH (DO)
Entity type:Individual
Prefix:DR
First Name:JAMI
Middle Name:BETH
Last Name:SCANLON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JAMI
Other - Middle Name:BETH
Other - Last Name:SILVER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:PO BOX 15849
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-2549
Mailing Address - Country:US
Mailing Address - Phone:912-303-3560
Mailing Address - Fax:912-303-3506
Practice Address - Street 1:310 EISENHOWER DR
Practice Address - Street 2:BLDG 16
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-2632
Practice Address - Country:US
Practice Address - Phone:912-303-3500
Practice Address - Fax:912-303-3509
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB07383700208000000X
GA066638208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics