Individual
SCOTT DAVID DIDIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
6019 WALNUT GROVE, MEMPHIS, TN 38120
(901) 383-8860
(901) 383-8985
Mailing address
PO BOX 2121, MEMPHIS, TN 38159
(901) 383-8860
(901) 383-8985
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
MD0000039188
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27499
MEDICAL LICENSURE COMMISS
AL
01
—
E4150
MEDICAL BOARD
AR
01
—
W0717958
BOARD OF MEDICAL LICENSE
MS
Enumeration date
03/30/2007
Last updated
07/19/2007
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