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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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