Healthcare Provider Details

I. General information

NPI: 1285619403
Provider Name (Legal Business Name): SCOTT ALAN GRUMLEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/09/2005
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1802 6TH AVE S
BIRMINGHAM AL
35233-1932
US

IV. Provider business mailing address

3641 DOVER DR
MOUNTAIN BRK AL
35223-2875
US

V. Phone/Fax

Practice location:
  • Phone: 205-934-7133
  • Fax: 205-975-4413
Mailing address:
  • Phone: 205-410-6884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number00021148
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: