Healthcare Provider Details

I. General information

NPI: 1649365651
Provider Name (Legal Business Name): SCOTT W.F. CARLE M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/04/2006
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10101 MABELVALE PLAZA, STE 3
LITTLE ROCK AR
72205
US

IV. Provider business mailing address

12 EDENFIELD CV
LITTLE ROCK AR
72212-2667
US

V. Phone/Fax

Practice location:
  • Phone: 501-568-7868
  • Fax: 501-568-3035
Mailing address:
  • Phone: 501-960-4137
  • Fax: 501-227-4542

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0500X
TaxonomyPreventive Medicine/Occupational Environmental Medicine Physician
License NumberC6583
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: