Provider Demographics
NPI:1932123510
Name:SCOOTER DIGGES AND ASSOCIATES, PC
Entity Type:Organization
Organization Name:SCOOTER DIGGES AND ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:NICHOLAS
Authorized Official - Last Name:DIGGES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:405-607-8222
Mailing Address - Street 1:4140 W MEMORIAL RD
Mailing Address - Street 2:SUITE 116
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73120-8366
Mailing Address - Country:US
Mailing Address - Phone:405-607-8222
Mailing Address - Fax:866-322-0876
Practice Address - Street 1:4140 W MEMORIAL AVE
Practice Address - Street 2:SUITE 116
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73120-8300
Practice Address - Country:US
Practice Address - Phone:405-607-8222
Practice Address - Fax:866-322-0876
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-27
Last Update Date:2014-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK24718174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
I32209Medicare UPIN