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General NPI Number Information
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NPI Number | 1447219878
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Entity Type | Individual
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Provider Name | LOUBNA T SCALLY M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/23/2006
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Last Update Date | 01/23/2023
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Provider Practice Location Address
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Address Line | 1111 S JEFFERSON ST STE B
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City | ROANOKE
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State | VA
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Zip | 24016-4724
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Country | US
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Telephone | 540-769-3964
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Fax | 540-342-2193
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Provider Business Mailing Address
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Address Line | PO BOX 8310
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City | ROANOKE
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State | VA
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Zip | 24014-0310
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Country | US
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Telephone | 540-345-3556
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Fax | 540-342-2193
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0300X
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Taxonomy Name | Geriatric Medicine (Internal Medicine) Physician
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License Number | 0101276310
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | MD2012-0012
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License Number State | NM
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Taxonomy #3
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 21776
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License Number State | WV
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Taxonomy #4
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Taxonomy Code | 2085R0001X
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Taxonomy Name | Radiation Oncology Physician
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License Number | 01063079A
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License Number State | IN
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Taxonomy #5
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD2012-0012
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License Number State | NM
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Taxonomy #6
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | ME156131
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License Number State | FL
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