Provider Demographics
NPI:1982657169
Name:SCRUGGS, JAN WRIGHT (MD)
Entity Type:Individual
Prefix:DR
First Name:JAN
Middle Name:WRIGHT
Last Name:SCRUGGS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3401 SPRINGHILL DRIVE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:NORTH LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72117-2926
Mailing Address - Country:US
Mailing Address - Phone:501-758-7627
Mailing Address - Fax:501-758-9499
Practice Address - Street 1:3401 SPRINGHILL DRIVE
Practice Address - Street 2:SUITE 250
Practice Address - City:NORTH LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72117-2926
Practice Address - Country:US
Practice Address - Phone:501-758-7627
Practice Address - Fax:501-758-9499
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC4858207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
B90556Medicare UPIN
AR54729Medicare ID - Type Unspecified