Provider Demographics
NPI:1861450967
Name:SCOTT, HENRY ELDON III (MD)
Entity Type:Individual
Prefix:
First Name:HENRY
Middle Name:ELDON
Last Name:SCOTT
Suffix:III
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:101 MEMORIAL HOSPITAL DR
Mailing Address - Street 2:SUITE 301
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36608-1787
Mailing Address - Country:US
Mailing Address - Phone:251-344-4182
Mailing Address - Fax:
Practice Address - Street 1:101 MEMORIAL HOSPITAL DR
Practice Address - Street 2:SUITE 301
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1787
Practice Address - Country:US
Practice Address - Phone:251-344-1800
Practice Address - Fax:251-341-1075
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-01
Last Update Date:2010-09-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL7875208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1710203OtherUNITED HEALTHCARE
AL020031620OtherRAILROAD MEDICARE
AL1710203OtherUNITED HEALTHCARE
C70997Medicare UPIN