Provider Demographics
NPI:1336404664
Name:SCOGGIN, MERLYN (MD)
Entity Type:Individual
Prefix:
First Name:MERLYN
Middle Name:
Last Name:SCOGGIN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:820 WALL ST
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73069-6302
Mailing Address - Country:US
Mailing Address - Phone:951-684-2627
Mailing Address - Fax:951-263-7260
Practice Address - Street 1:820 WALL ST
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-6302
Practice Address - Country:US
Practice Address - Phone:951-684-2627
Practice Address - Fax:951-263-7260
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA1429442084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry