Provider Demographics
NPI:1215022793
Name:WARRIOR MEDICAL ASSOCIATES, PC
Entity type:Organization
Organization Name:WARRIOR MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:ASHLEY
Authorized Official - Middle Name:
Authorized Official - Last Name:CARR SCOGGINS
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:205-647-6333
Mailing Address - Street 1:100 DANA ROAD
Mailing Address - Street 2:
Mailing Address - City:WARRIOR
Mailing Address - State:AL
Mailing Address - Zip Code:35180
Mailing Address - Country:US
Mailing Address - Phone:205-647-6333
Mailing Address - Fax:205-647-8666
Practice Address - Street 1:100 DANA ROAD
Practice Address - Street 2:
Practice Address - City:WARRIOR
Practice Address - State:AL
Practice Address - Zip Code:35180
Practice Address - Country:US
Practice Address - Phone:205-647-6333
Practice Address - Fax:205-647-8666
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2019-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL529910250Medicaid