Basic Information
| Provider Information | |||||||||
| NPI: | 1396802351 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCARBROUGH | ||||||||
| FirstName: | CATHERINE | ||||||||
| MiddleName: | P. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 850 PETER BRYCE BLVD | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | TUSCALOOSA | ||||||||
| State: | AL | ||||||||
| PostalCode: | 354017419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2053481770 | ||||||||
| FaxNumber: | 2053486561 | ||||||||
| Practice Location | |||||||||
| Address1: | 1026 GOODYEAR AVE STE 100 | ||||||||
| Address2: | |||||||||
| City: | GADSDEN | ||||||||
| State: | AL | ||||||||
| PostalCode: | 359031194 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2564928256 | ||||||||
| FaxNumber: | 5649282712 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/02/2007 | ||||||||
| LastUpdateDate: | 01/27/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 01/27/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 24664 | OK | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 28973 | AL | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1396802351 | 05 | AL | MEDICAID | 28973 | 01 | AL | MEDICAL LICENSE | OTHER |