Provider Demographics
NPI:1447296520
Name:DANIEL, JAMES SCALES (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:SCALES
Last Name:DANIEL
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 1:721 E 10TH ST
Mailing Address - Street 2:
Mailing Address - City:ANNISTON
Mailing Address - State:AL
Mailing Address - Zip Code:36207-4785
Mailing Address - Country:US
Mailing Address - Phone:253-236-9995
Mailing Address - Fax:256-236-9908
Practice Address - Street 1:721 E 10TH ST
Practice Address - Street 2:
Practice Address - City:ANNISTON
Practice Address - State:AL
Practice Address - Zip Code:36207-4785
Practice Address - Country:US
Practice Address - Phone:253-236-9995
Practice Address - Fax:256-236-9908
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2015-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL12614174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL000044526Medicaid
C74700Medicare UPIN