Provider Demographics
NPI:1578532792
Name:RONALD SCOTT EXUM M.D. P.A.
Entity Type:Organization
Organization Name:RONALD SCOTT EXUM M.D. P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RONALD
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:EXUM
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:501-245-1200
Mailing Address - Street 1:3050 TWIN RIVERS DR
Mailing Address - Street 2:
Mailing Address - City:ARKADELPHIA
Mailing Address - State:AR
Mailing Address - Zip Code:71923-4218
Mailing Address - Country:US
Mailing Address - Phone:501-245-1200
Mailing Address - Fax:501-245-2377
Practice Address - Street 1:3050 TWIN RIVERS DR
Practice Address - Street 2:
Practice Address - City:ARKADELPHIA
Practice Address - State:AR
Practice Address - Zip Code:71923-4218
Practice Address - Country:US
Practice Address - Phone:501-245-1200
Practice Address - Fax:501-245-2377
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-17
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC-7916208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208M00000XAllopathic & Osteopathic PhysiciansHospitalistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
F34928Medicare UPIN
#5J060Medicare ID - Type Unspecified