Scroggins, John W

Scroggins, John W is an individual health care provider with primary practice located at 8288 S Broadway Ave , Tyler TX 75703-5262. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Scroggins, John W can be contacted via phone (903) 606-7060.

Contact Information

Primary practice address
8288 S Broadway Ave Tyler TX 75703-5262
Phone: (903) 606-7060
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X F1239 Texas

Profile Details

NPI number 1003881608
LBN Legal business name Scroggins, John W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Oct 14th, 2014 - about 12 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003881608 NPPES
Texas MEDICAID 129527104
Texas MEDICAID 288855402
Texas Other 752616977118
Texas Other 75-2616977-042
Texas Other 8DC106
Texas MEDICAID 129527106

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