Healthcare Provider Details

I. General information

NPI: 1407888456
Provider Name (Legal Business Name): SCOTT E CALDWELL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 05/12/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CHASE CORPORATE DR STE 225
HOOVER AL
35244-1026
US

IV. Provider business mailing address

1 CHASE CORPORATE DR STE 225
HOOVER AL
35244-1026
US

V. Phone/Fax

Practice location:
  • Phone: 205-733-6033
  • Fax: 205-733-6036
Mailing address:
  • Phone: 205-733-6033
  • Fax: 205-733-6036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number24994
License Number StateAL
# 2
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number24994
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: