Individual
MS. STACY LYNN SCROGGINS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
3101 ELKS ROAD, MCALESTER, OK 74501
(918) 426-2442
(918) 423-4905
Mailing address
101 E. OKLAHOMA, MCALESTER, OK 74501
(918) 423-4900
(918) 423-4905
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1066
OK
363A00000X
Physician Assistant
PA1066
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100228530A
—
OK
01
—
100739490N
SOONER CARE PCP
—
Enumeration date
04/06/2006
Last updated
03/27/2025
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