Organization
SCARBROUGH CLINIC, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TAD SCARBROUGH APRN, DC (FNP/CHIROPRACTOR/PRESIDENT)
(870) 238-8707
Entity
Organization
Contact information
Practice address
1901 KILLOUGH RD. NORTH, WYNNE, AR 72396-2465
(870) 238-8707
(870) 238-8711
Mailing address
PO BOX 572, WYNNE, AR 72396-0572
(870) 238-8707
(870) 533-5573
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1544
AR
164W00000X
Licensed Practical Nurse
P01329
AR
363LF0000X
Family Nurse Practitioner
Primary
P01329
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158844718
—
AR
01
—
19754000040
QUALCHOICE ID NUMBER
AR
01
—
3821243
CIGNA ID NUMBER
AR
01
—
5U931
AR BLUECROSSBLUESHIELD
AR
01
—
647764
UNITED HEALTHCARE ID #
AR
01
—
7359415
AETNA ID NUMBER
AR
Enumeration date
09/22/2006
Last updated
12/13/2021
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