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Individual

JOHNNY SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
619 19TH STREET SOUTH, BIRMINGHAM, AL 35233
(205) 934-6600
Mailing address
PO BOX 55310, BIRMINGHAM, AL 35255-5310

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
7548
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000005540
AL
05
009937174
AL
01
051534696
BCBS
AL
01
300059424
RR MEDICARE
AL
01
D32905
VIVA
AL
Enumeration date
10/03/2006
Last updated
08/04/2011
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