Provider Demographics
NPI:1275925513
Name:STEPHEN L. SCRANTON, M.D.
Entity Type:Organization
Organization Name:STEPHEN L. SCRANTON, M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:LLOYD
Authorized Official - Last Name:SCRANTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:727-725-6174
Mailing Address - Street 1:PO BOX 766
Mailing Address - Street 2:
Mailing Address - City:DUNEDIN
Mailing Address - State:FL
Mailing Address - Zip Code:34697-0766
Mailing Address - Country:US
Mailing Address - Phone:727-738-8416
Mailing Address - Fax:727-736-8812
Practice Address - Street 1:3253 N MCMULLEN BOOTH RD
Practice Address - Street 2:SUITE 200
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33761-2043
Practice Address - Country:US
Practice Address - Phone:727-725-6174
Practice Address - Fax:727-799-1521
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-02-24
Last Update Date:2015-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME37761207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLP00221159OtherRAILROAD MEDICARE
FL30450OtherBCBS
FL110243960OtherRAILROAD MEDICARE
FL110243960OtherRAILROAD MEDICARE
FL30450OtherBCBS