Provider Demographics
NPI:1467434498
Name:MCCORD, ROBERT SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:SCOTT
Last Name:MCCORD
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 1:817 PRINCETON AVENUE SW
Mailing Address - Street 2:SUITE 306
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35211
Mailing Address - Country:US
Mailing Address - Phone:205-783-0160
Mailing Address - Fax:205-788-6249
Practice Address - Street 1:817 PRINCETON AVENUE SW
Practice Address - Street 2:SUITE 306
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35211
Practice Address - Country:US
Practice Address - Phone:205-783-0160
Practice Address - Fax:205-788-6249
Is Sole Proprietor?:No
Enumeration Date:2005-11-16
Last Update Date:2009-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL000190812086S0129X
AL190812086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000024104Medicaid
ALROBE1493791OtherUMWA
AL24104MCCOtherCHAMPUS
AL770000790OtherPALMETTO GOVERNMENT BENEF
ALCL1402OtherRRM
ALG05553OtherSENIORSFIRST
AL3710065OtherMEDICARE COMPLETE
AL3710065OtherUNITEDHEALTH CARE
AL009914025Medicaid
AL51528777OtherBLUE CROSS
AL009914045Medicaid
ALG05553OtherHEALTH SPRING
ALG05553OtherVIVA HEALTH CARE
AL009914035Medicaid
AL009932174Medicaid
AL009914015Medicaid
AL51024104OtherBLUE CROSS
AL000024104Medicaid
AL770000790Medicare PIN
AL009914025Medicaid