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General NPI Number Information
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NPI Number | 1851527923
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Entity Type | Organization
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Legal Business Name | SCOTTSBORO INTERNAL MEDICINE, PC
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 10/25/2011
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Provider Practice Location Address
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Address Line | SUITE 400, 1508 SOUTH BROAD STREET
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City | SCOTTSBORO
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State | AL
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Zip | 35768-2668
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Country | US
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Telephone | 256-259-3344
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Fax | 256-259-3355
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Provider Business Mailing Address
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Address Line | PO BOX 1629 SUITE 400, 1508 SOUTH BROAD STREET
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City | SCOTTSBORO
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State | AL
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Zip | 35768-6129
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Country | US
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Telephone | 256-259-3344
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Fax | 256-259-3355
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Authorized Official
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Title or Position | PRESIDENT
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Name | JUNAID H MEMON
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Credential | MD.
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Telephone | 256-259-3344
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 24327
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License Number State | AL
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