Provider Demographics
NPI:1720034317
Name:DAVIS, SCOTT A (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:A
Last Name:DAVIS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:9501 LILE DR
Mailing Address - Street 2:STE 600
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6231
Mailing Address - Country:US
Mailing Address - Phone:501-227-7596
Mailing Address - Fax:501-227-7787
Practice Address - Street 1:9501 LILE DR
Practice Address - Street 2:STE 600
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6231
Practice Address - Country:US
Practice Address - Phone:501-227-7596
Practice Address - Fax:501-227-7787
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2011-10-04
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
ARC8248207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARCC6745OtherRAILROAD MEDICARE
AR5K821OtherBLUE CROSS BLUE SHIELD
AR134487001Medicaid
ARCN1884OtherRAILROAD MEDICARE
G49603Medicare UPIN
AR134487001Medicaid