Provider Demographics
NPI:1447238951
Name:CHARLTON, SCOTT ASHLEY (MD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ASHLEY
Last Name:CHARLTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 311105
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36331-1105
Mailing Address - Country:US
Mailing Address - Phone:334-308-9368
Mailing Address - Fax:334-393-7011
Practice Address - Street 1:101 E BRUNSON ST
Practice Address - Street 2:SUITE 102
Practice Address - City:ENTERPRISE
Practice Address - State:AL
Practice Address - Zip Code:36330-2526
Practice Address - Country:US
Practice Address - Phone:334-308-9368
Practice Address - Fax:334-308-3277
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2018-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL22530207K00000X, 207KA0200X, 207Y00000X, 207YP0228X, 207YS0123X, 207YX0007X, 207YX0602X, 207YX0905X
ALMD.22530207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No207YX0905XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngology/Facial Plastic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL009962010Medicaid
AL051504923Medicare PIN
ALG33969Medicare UPIN