Provider Demographics
NPI:1851527923
Name:SCOTTSBORO INTERNAL MEDICINE, PC
Entity Type:Organization
Organization Name:SCOTTSBORO INTERNAL MEDICINE, PC
Other - Org Name:JUNAID MEMON MD.
Other - Org Type:Other Name
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JUNAID
Authorized Official - Middle Name:H
Authorized Official - Last Name:MEMON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:256-259-3344
Mailing Address - Street 1:PO BOX 1629
Mailing Address - Street 2:SUITE 400, 1508 SOUTH BROAD STREET
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35768-6129
Mailing Address - Country:US
Mailing Address - Phone:256-259-3344
Mailing Address - Fax:256-259-3355
Practice Address - Street 1:SUITE 400, 1508 SOUTH BROAD STREET
Practice Address - Street 2:
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35768-2668
Practice Address - Country:US
Practice Address - Phone:256-259-3344
Practice Address - Fax:256-259-3355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-06-03
Last Update Date:2011-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL24327207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty