Provider Demographics
NPI:1508114406
Name:SCRUGGS, LOY P JR (CSFA)
Entity Type:Individual
Prefix:
First Name:LOY
Middle Name:P
Last Name:SCRUGGS
Suffix:JR
Gender:M
Credentials:CSFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3313 COUNTY ROAD 4216
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:75766-7334
Mailing Address - Country:US
Mailing Address - Phone:903-372-9803
Mailing Address - Fax:
Practice Address - Street 1:3313 COUNTY ROAD 4216
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:TX
Practice Address - Zip Code:75766-7334
Practice Address - Country:US
Practice Address - Phone:903-372-9803
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-27
Last Update Date:2012-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other