Individual
CHARLES R SCOGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
401 E CHESTNUT ST, SUITE 710, LOUISVILLE, KY 40202
(502) 583-8303
(502) 584-0302
Mailing address
PO BOX 909, LOUISVILLE, KY 40201-0909
(502) 588-0328
(502) 588-0326
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
38734
KY
2086X0206X
Surgical Oncology Physician
Primary
38734
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200489960
—
IN
01
—
50005061
PASSPORT
KY
05
—
64081078
—
KY
Enumeration date
01/17/2006
Last updated
06/27/2018
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