Provider Demographics
NPI:1598771958
Name:SCRUTON, SCOTT DANIEL (CRNA)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DANIEL
Last Name:SCRUTON
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1614 NE GREENBRIER RD
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72712-8446
Mailing Address - Country:US
Mailing Address - Phone:479-273-2884
Mailing Address - Fax:479-273-2884
Practice Address - Street 1:1614 NE GREENBRIER RD
Practice Address - Street 2:
Practice Address - City:BENTONVILLE
Practice Address - State:AR
Practice Address - Zip Code:72712-8446
Practice Address - Country:US
Practice Address - Phone:479-273-2884
Practice Address - Fax:479-273-2884
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC01574367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered