Individual
SCOTT BAILEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Mailing address
2100 W MAIN ST, RUSSELLVILLE, AR 72801-2758
(479) 968-2525
(479) 968-2538
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OTR2959
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
216055721
—
AR
01
—
5BW85
ARKANSAS BLUE CROSS BLUE SHIELD
—
01
—
710857801
QUALCHOICE
AR
01
—
A002
TRICARE
AR
Enumeration date
09/16/2016
Last updated
12/29/2016
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