Organization
SCOTT EYE CLINIC PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. HENRY KEITH SCOTT OD (OWNER/PHYSICIAN)
(479) 968-3937
Entity
Organization
Contact information
Practice address
214 E 4TH ST, RUSSELLVILLE, AR 72801-5134
(479) 968-3937
(479) 967-6731
Mailing address
214 E 4TH ST, RUSSELLVILLE, AR 72801-5134
(479) 968-3937
(479) 967-6731
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2349
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1114115433
MEDICARE NSC
AR
05
—
146049722
—
AR
05
—
148782722
—
AR
Enumeration date
10/11/2007
Last updated
02/12/2018
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