Provider Demographics
NPI:1588609960
Name:DORIN, SCOTT EDWARD (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:EDWARD
Last Name:DORIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:216 MARENGO ST
Mailing Address - Street 2:UNIT K
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-6012
Mailing Address - Country:US
Mailing Address - Phone:256-740-0601
Mailing Address - Fax:256-740-0687
Practice Address - Street 1:216 MARENGO ST
Practice Address - Street 2:UNIT K
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-6012
Practice Address - Country:US
Practice Address - Phone:256-740-0601
Practice Address - Fax:256-740-0687
Is Sole Proprietor?:No
Enumeration Date:2006-06-18
Last Update Date:2019-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL20298207WX0107X, 207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0107XAllopathic & Osteopathic PhysiciansOphthalmologyRetina Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL051550554Medicaid
AL051550554Medicaid
AL051550554Medicare ID - Type Unspecified