Provider Demographics
NPI:1346421369
Name:THOMPSON, SCOTT BAILEY (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:BAILEY
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2000A SOUTHBRIDGE PKWY
Mailing Address - Street 2:STE 300
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35209-7718
Mailing Address - Country:US
Mailing Address - Phone:205-871-4274
Mailing Address - Fax:205-871-4301
Practice Address - Street 1:619 19TH ST S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35249-1900
Practice Address - Country:US
Practice Address - Phone:205-934-4011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL293242085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051116332OtherBCBS
AL051116349OtherBCBS
AL129409Medicaid
AL140641Medicaid
AL140643Medicaid
AL511-26252OtherBLUE CROSS
AL051116337OtherBCBS
AL129362Medicaid
AL140695Medicaid
AL511-26281OtherBLUE CROSS
AL051116345OtherBCBS
AL129366Medicaid
AL129367Medicaid
AL140693Medicaid
AL140774Medicaid
AL9210720OtherAETNA
AL051116350OtherBCBS
AL129406Medicaid
AL129407Medicaid
AL511-26249OtherBLUE CROSS
MS02623890Medicaid
AL051116347OtherBCBS
AL051116348OtherBCBS
AL129365Medicaid
AL140692Medicaid
AL511-26279OtherBLUE CROSS
AL129361Medicaid
AL051116346OtherBCBS
AL511-26278OtherBLUE CROSS
AL051116331OtherBCBS
AL051116338OtherBCBS
AL129359Medicaid
AL129360Medicaid
AL511-26280OtherBLUE CROSS
AL102I305369Medicare PIN