Individual
SCOTT C CLAYCOMB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
301 HIGHWAY 425 S, MONTICELLO, AR 71655-4611
(870) 367-8534
(870) 367-0264
Mailing address
301 HIGHWAY 425 S, MONTICELLO, AR 71655-4611
(870) 367-8534
(870) 367-0264
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
C7907
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1180870001
—
AR
05
—
118087001
—
AR
05
—
128298002
—
AR
01
—
16703
QUALCHOICE
—
01
—
180024861
RAILROAD MEDICARE
AR
01
—
54339
BLUE CROSS OF AR
AR
Enumeration date
06/21/2005
Last updated
09/02/2014
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