Provider Demographics
NPI:1750707824
Name:SCOTT D PARKER MD LLC
Entity type:Organization
Organization Name:SCOTT D PARKER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SANDRA
Authorized Official - Middle Name:
Authorized Official - Last Name:TEBBEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:256-612-9427
Mailing Address - Street 1:250 CHATEAU DR SW STE 115
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-3497
Mailing Address - Country:US
Mailing Address - Phone:256-533-4645
Mailing Address - Fax:256-808-3178
Practice Address - Street 1:250 CHATEAU DR SW STE 115
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-3497
Practice Address - Country:US
Practice Address - Phone:256-533-4645
Practice Address - Fax:256-808-3178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-12
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious DiseaseGroup - Single Specialty
No261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical SpecialtyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1992716120OtherNPI