Provider Demographics
NPI:1568442655
Name:SOVAR, SCOTT R (DC)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:SOVAR
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2816 VEACH RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:OWENSBORO
Mailing Address - State:KY
Mailing Address - Zip Code:42303-6295
Mailing Address - Country:US
Mailing Address - Phone:270-684-4101
Mailing Address - Fax:812-649-4927
Practice Address - Street 1:826 N STATE ROAD 161 STE D
Practice Address - Street 2:
Practice Address - City:ROCKPORT
Practice Address - State:IN
Practice Address - Zip Code:47635-9249
Practice Address - Country:US
Practice Address - Phone:812-649-4926
Practice Address - Fax:812-649-4927
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-17
Last Update Date:2022-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO006209111N00000X
KY250353111N00000X
IN08002032A111N00000X
KY4286111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200391820AMedicaid
KY85002871Medicaid
IN200391820AMedicaid
IN198880Medicare PIN
KY6107201Medicare PIN