Healthcare Provider Details

I. General information

NPI: 1699755744
Provider Name (Legal Business Name): SCOTT A SALMON MD, MPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/17/2006
Last Update Date: 05/24/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

301 ANDREWS AVENUE
FT. RUCKER AL
36362-5333
US

IV. Provider business mailing address

102 HIDDEN CREEK CIR
ENTERPRISE AL
36330-8574
US

V. Phone/Fax

Practice location:
  • Phone: 334-255-7334
  • Fax: 334-255-7475
Mailing address:
  • Phone: 334-464-0696
  • Fax: 334-255-7475

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License Number024043
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: