MEDICARE: SCOTT ALAN GRUMLEY MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2085R0202X	Diagnostic Radiology Physician	00021148	AL

General Provider Information

NPI Number	:	1285619403
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT ALAN GRUMLEY MD

Provider Business Mailing Address
First Line	:	PO BOX 1328
Second Line	:
City	:	JASPER
State	:	AL
Zip	:	35502-1328
Country	:	US
Telephone Number	:	205-221-3523
Fax Number	:	205-221-3560

Provider Business Practice Location Address
First Line	:	1450 JONES DAIRY RD
Second Line	:
City	:	JASPER
State	:	AL
Zip	:	35501-6106
Country	:	US
Telephone Number	:	205-295-4110
Fax Number	:	205-952-4101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2005
Last Update Date	:	04/12/2018

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Directions to “ SCOTT ALAN GRUMLEY MD” Practice Location

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