Provider Demographics
NPI:1821577941
Name:SCOGGINS, ASHTON DELAINE (DPT)
Entity Type:Individual
Prefix:
First Name:ASHTON
Middle Name:DELAINE
Last Name:SCOGGINS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6513 CURRY CT
Mailing Address - Street 2:
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72116-5103
Mailing Address - Country:US
Mailing Address - Phone:870-489-7400
Mailing Address - Fax:
Practice Address - Street 1:2801 S OLIVE ST STE 9D
Practice Address - Street 2:
Practice Address - City:PINE BLUFF
Practice Address - State:AR
Practice Address - Zip Code:71603-5495
Practice Address - Country:US
Practice Address - Phone:870-541-0003
Practice Address - Fax:870-541-0008
Is Sole Proprietor?:No
Enumeration Date:2018-08-09
Last Update Date:2018-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT4518225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist