# SAM SCROGGINS MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1275628596
- **Authorized official:** MRS. CATHY I SCROGGGINS (OFFICE MANAGER)
- **Authorized official phone:** (870) 741-6373

## Contact information

- **Practice address:** 1002 N SPRING ST, HARRISON, AR 72601
- **Practice address phone:** (870) 741-6373
- **Practice address fax:** (870) 741-5102
- **Mailing address:** 1002 N SPRING ST, HARRISON, AR 72601
- **Mailing address phone:** (870) 741-6373
- **Mailing address fax:** (870) 741-5102

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | C4664 | AR | Yes |

## Other

- **Enumeration date:** 10/03/2006
- **Last updated:** 06/17/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 110143007 | — | AR |
| 01 | — | 13888000000 | QUALCHOICE | AR |
| 01 | — | 5B000 | BLUE CROSS BLUE SHIELD | AR |