Provider Demographics
NPI:1205267150
Name:SCOTTSBORO URGENT CARE
Entity type:Organization
Organization Name:SCOTTSBORO URGENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF PHYSICIAN SERVICES
Authorized Official - Prefix:
Authorized Official - First Name:KAREN
Authorized Official - Middle Name:
Authorized Official - Last Name:GRIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-218-3856
Mailing Address - Street 1:102 MICAH WAY
Mailing Address - Street 2:SUITE 1107
Mailing Address - City:SCOTTSBORO
Mailing Address - State:AL
Mailing Address - Zip Code:35769-4160
Mailing Address - Country:US
Mailing Address - Phone:256-259-4802
Mailing Address - Fax:256-218-3536
Practice Address - Street 1:102 MICAH WAY
Practice Address - Street 2:SUITE 1107
Practice Address - City:SCOTTSBORO
Practice Address - State:AL
Practice Address - Zip Code:35769-4160
Practice Address - Country:US
Practice Address - Phone:256-259-4802
Practice Address - Fax:256-218-3536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-03
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty