Healthcare Provider Details

I. General information

NPI: 1710308473
Provider Name (Legal Business Name): TONIA SCALES I BS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MRS. TONIA STOVALL

II. Dates (important events)

Enumeration Date: 12/26/2013
Last Update Date: 12/26/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 NTH ROCKINGCHAIR RD
PARAGOULD AR
72450
US

IV. Provider business mailing address

6903 DEERWOOD DR
PARAGOULD AR
72450-7428
US

V. Phone/Fax

Practice location:
  • Phone: 870-335-9617
  • Fax: 870-335-9618
Mailing address:
  • Phone: 870-565-8806
  • Fax: 870-335-9618

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: