MEDICARE: MALLORY SCOGIN M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207V00000X	Obstetrics & Gynecology Physician	38082	AL

General Provider Information

NPI Number	:	1114312840
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MALLORY SCOGIN M.D.

Provider Business Mailing Address
First Line	:	800 SAINT VINCENTS DR STE 600
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1630
Country	:	US
Telephone Number	:	205-271-1600
Fax Number	:	205-271-3180

Provider Business Practice Location Address
First Line	:	800 SAINT VINCENTS DR STE 600
Second Line	:
City	:	BIRMINGHAM
State	:	AL
Zip	:	35205-1630
Country	:	US
Telephone Number	:	205-271-1600
Fax Number	:	205-271-3180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2015
Last Update Date	:	10/11/2021

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Directions to “ MALLORY SCOGIN M.D.” Practice Location

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