Stegall, Scott

Stegall, Scott is an individual health care provider with primary practice located at 5414 S Broadway Ave , Tyler TX 75703-1335. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Stegall, Scott can be contacted via phone (903) 581-1601.

Contact Information

Primary practice address
5414 S Broadway Ave Tyler TX 75703-1335
Phone: (903) 581-1601
Fax: (903) 581-1638
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X PA01268 Texas

Profile Details

NPI number 1356323034
LBN Legal business name Stegall, Scott
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 17th, 2005
Last updated Jul 17th, 2017 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1356323034 NPPES
Texas Other 8854MB BCBS
Texas Other 8780MD BCBS
Texas MEDICAID 337197303 BCBS
Texas Other P01811994 BCBS
Texas Other P01811499 BCBS
Texas MEDICAID 337197302 BCBS

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