Individual
NICOLE M. SCALLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2000 S PROMENADE BLVD, SUITE 202, ROGERS, AR 72758-9073
(479) 282-2737
(479) 316-4072
Mailing address
2000 S PROMENADE BLVD, SUITE 202, ROGERS, AR 72758-9073
(479) 282-2737
(479) 316-4072
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
2005-0737
NM
207Q00000X
Family Medicine Physician
Primary
E-5959
AR
207V00000X
Obstetrics & Gynecology Physician
E-5959
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176772001
—
AR
Enumeration date
02/06/2007
Last updated
12/03/2015
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