Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | 30195 | KS |
NPI | 1043247430 |
---|---|
Provider Name | Thomas A Scott |
First Address | Birmingham, AL 35209-6802 |
Second Address | Bessemer, AL 35022-7839 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 23/07/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
100453270A | (05) | KS |
102849 | BCBS (01) | KS |
12149485 | MULTIPLAN (01) | KS |
138739 | COVENTRY (01) | KS |
203531 | HPK (01) | KS |
6491 | PHS (01) | KS |
F64025 | (02) |