Provider Demographics
NPI:1558772558
Name:SCOGGIN, DARREN THOMAS (MD)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:THOMAS
Last Name:SCOGGIN
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 1:1867 CRANE RIDGE DRIVE
Mailing Address - Street 2:SUITE 101B
Mailing Address - City:JACKSON
Mailing Address - State:MS
Mailing Address - Zip Code:39216
Mailing Address - Country:US
Mailing Address - Phone:601-362-8776
Mailing Address - Fax:601-354-8786
Practice Address - Street 1:1867 CRANE RIDGE DRIVE
Practice Address - Street 2:SUITE 101B
Practice Address - City:JACKSON
Practice Address - State:MS
Practice Address - Zip Code:39216
Practice Address - Country:US
Practice Address - Phone:603-362-8776
Practice Address - Fax:601-354-8786
Is Sole Proprietor?:No
Enumeration Date:2014-05-13
Last Update Date:2017-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program