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Organization
SAM SCROGGINS MD PA
Active
Organization
SAM SCROGGINS MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CATHY I SCROGGGINS (OFFICE MANAGER)
(870) 741-6373
Entity
Organization
Contact information
Practice address
1002 N SPRING ST, HARRISON, AR 72601
(870) 741-6373
(870) 741-5102
Mailing address
1002 N SPRING ST, HARRISON, AR 72601
(870) 741-6373
(870) 741-5102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C4664
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110143007
—
AR
01
—
13888000000
QUALCHOICE
AR
01
—
5B000
BLUE CROSS BLUE SHIELD
AR
Enumeration date
10/03/2006
Last updated
06/17/2008
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