Individual
MR. SCOTT ALAN SOUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
P.A.
Contact information
Practice address
25 N WINFIELD RD, WINFIELD, IL 60190-1379
(630) 232-0280
Mailing address
4683 MCGILL CT, HOOVER, AL 35226-6000
(205) 335-8688
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085006027
IL
363A00000X
Physician Assistant
TA1704
AL
363AS0400X
Surgical Physician Assistant
695
AL
Other
Enumeration date
03/02/2010
Last updated
02/15/2022
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