Provider Demographics
NPI:1023489929
Name:SCROGGINS, JOSEPH
Entity type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:
Last Name:SCROGGINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 152487
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78715-2487
Mailing Address - Country:US
Mailing Address - Phone:512-271-9424
Mailing Address - Fax:
Practice Address - Street 1:10001 S 1ST ST
Practice Address - Street 2:214
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78748-6686
Practice Address - Country:US
Practice Address - Phone:512-271-9424
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-10-18
Last Update Date:2015-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor