Organization
TIMOTHY A. SCROGGINS, MD, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHARLYN SUE SCROGGINS (MEDICAL ASSISTANT)
(330) 648-9060
Entity
Organization
Contact information
Practice address
110 S JACKSON ST, SUITE 8, SPENCER, OH 44275-9569
(330) 648-9060
(330) 667-1011
Mailing address
5666 RICHMAN RD, SPENCER, OH 44275-9788
(330) 648-9060
(330) 667-1011
Taxonomy
Speciality
Code
Description
License number
State
305S00000X
Point of Service
Primary
OH35079345S
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000314569
ANTHEM
OH
05
—
2275121
—
OH
01
—
454419230004
MEDICAL MUTUAL
OH
01
—
5938111
AETNA
OH
01
—
DB2733
MEDICARE RAILROAD
OH
Enumeration date
04/08/2008
Last updated
04/08/2008
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