Provider Demographics
NPI:1689639338
Name:SCOTT, BILLY DON (DC)
Entity Type:Individual
Prefix:DR
First Name:BILLY
Middle Name:DON
Last Name:SCOTT
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:PO BOX 37
Mailing Address - Street 2:
Mailing Address - City:JACKSONPORT
Mailing Address - State:AR
Mailing Address - Zip Code:72075-0037
Mailing Address - Country:US
Mailing Address - Phone:870-523-8008
Mailing Address - Fax:870-523-8008
Practice Address - Street 1:310 DILLARD ST
Practice Address - Street 2:
Practice Address - City:NEWPORT
Practice Address - State:AR
Practice Address - Zip Code:72112-9169
Practice Address - Country:US
Practice Address - Phone:870-523-8008
Practice Address - Fax:870-523-8008
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR15650111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5X198Medicare UPIN