Provider Demographics
NPI:1821458605
Name:CAMPBELL, SCOTT EAGLESHAM (PA-C)
Entity Type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:EAGLESHAM
Last Name:CAMPBELL
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1415 BRECKENRIDGE DR
Mailing Address - Street 2:SUITE B
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72227-4819
Mailing Address - Country:US
Mailing Address - Phone:501-227-7797
Mailing Address - Fax:501-227-7753
Practice Address - Street 1:1415 BRECKENRIDGE DR
Practice Address - Street 2:SUITE B
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72227-4819
Practice Address - Country:US
Practice Address - Phone:501-227-7797
Practice Address - Fax:501-227-7753
Is Sole Proprietor?:No
Enumeration Date:2016-03-07
Last Update Date:2016-06-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARPA-664363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical