Provider Demographics
NPI:1114312840
Name:SCOGIN, MALLORY (MD)
Entity Type:Individual
Prefix:
First Name:MALLORY
Middle Name:
Last Name:SCOGIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 SAINT VINCENTS DR STE 600
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35205-1630
Mailing Address - Country:US
Mailing Address - Phone:205-271-1600
Mailing Address - Fax:205-271-3180
Practice Address - Street 1:800 SAINT VINCENTS DR STE 600
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35205-1630
Practice Address - Country:US
Practice Address - Phone:205-271-1600
Practice Address - Fax:205-271-3180
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-31
Last Update Date:2021-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL38082207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology