Healthcare Provider Details

I. General information

NPI: 1861553513
Provider Name (Legal Business Name): SCOTT JOHANN ARBAUGH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/13/2006
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9979 WINGHAVEN BLVD STE 202
O FALLON MO
63368-3628
US

IV. Provider business mailing address

9979 WINGHAVEN BLVD STE 202
O FALLON MO
63368-3628
US

V. Phone/Fax

Practice location:
  • Phone: 636-695-4554
  • Fax: 636-695-3099
Mailing address:
  • Phone: 636-695-4554
  • Fax: 636-695-3099

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number036-078716
License Number StateIL
# 2
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License NumberR5G44
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: