Provider Demographics
NPI:1932143666
Name:MEMON, JUNAID HASSAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JUNAID
Middle Name:HASSAN
Last Name:MEMON
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:PO BOX 1629
Mailing Address - Street 2:
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 1:1508 SOUTH BROAD STREET
Practice Address - Street 2:SUITE 400
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
Is Sole Proprietor?:No
Enumeration Date:2006-06-15
Last Update Date:2020-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL00024327207P00000X, 207R00000X
AL24327207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL04-11878OtherUNITED HEALTH CARE
AL1115484Medicaid
AL511 03481OtherBLUE CROSS BLUE SHIELD
ALP00104195OtherRAILROAD MEDICARE
AL009904535Medicaid
AL051551450Medicaid
AL51506430OtherBLUE CROSS BLUE SHIELD
AL541386403Medicaid
AL51511902OtherBLUE CROSS BLUE SHIELD
AL009932952Medicaid
AL541393501Medicaid
AL541386403Medicaid
ALP00104195OtherRAILROAD MEDICARE
AL051551450Medicare PIN