MEDICARE: SCOTT ACKLIN MATTHEWS 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	207R00000X	Internal Medicine Physician	25714	AL
2	207P00000X	Emergency Medicine Physician	MD25714	AL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	51529627	OTHER	AL	BCBS
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407823099
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT ACKLIN MATTHEWS MD

Provider Business Mailing Address
First Line	:	1201 SOMERVILLE RD SE
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-4340
Country	:	US
Telephone Number	:	256-584-8038
Fax Number	:	256-584-8136

Provider Business Practice Location Address
First Line	:	1201 SOMERVILLE RD SE
Second Line	:
City	:	DECATUR
State	:	AL
Zip	:	35601-4340
Country	:	US
Telephone Number	:	256-584-8038
Fax Number	:	256-584-8136

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

Provider Enumeration Date	:	03/02/2006
Last Update Date	:	10/31/2011

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Directions to “ SCOTT ACKLIN MATTHEWS MD” Practice Location

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