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Individual

DR. BETHANY JOHNSON NEMATI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
506 HARLEY ST, SCOTTSBORO, AL 35768-4219
(256) 259-1234
(256) 259-6838
Mailing address
506 HARLEY ST, SCOTTSBORO, AL 35768-4219
(256) 259-1234
(562) 596-8382

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
44085
AL
208000000X
Pediatrics Physician
Primary
LL82798
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1083955173
AL
Enumeration date
06/10/2019
Last updated
12/05/2022
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