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General NPI Number Information
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NPI Number | 1235312737
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Entity Type | Organization
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Legal Business Name | SCOTT C. CLAYCOMB, M.D., P.A.
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 08/28/2014
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Provider Practice Location Address
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Address Line | 301 HIGHWAY 425 S
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City | MONTICELLO
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State | AR
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Zip | 71655-4611
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Country | US
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Telephone | 870-367-8534
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Fax | 870-367-0264
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Provider Business Mailing Address
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Address Line | PO BOX 890
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City | WARREN
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State | AR
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Zip | 71671-0890
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Country | US
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Telephone | 870-367-8534
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Fax | 870-367-0264
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. SCOTT C CLAYCOMB
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Credential | M.D.
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Telephone | 870-367-8534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | C7907
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License Number State | AR
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