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General NPI Number Information
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NPI Number | 1609862838
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Entity Type | Individual
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Provider Name | ROGER D SCOW JR. MD
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Gender | Male
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Dates
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Enumeration Date | 09/22/2005
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Last Update Date | 12/27/2022
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Provider Practice Location Address
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Address Line | 712 W MAIN ST
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City | MAGNOLIA
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State | AR
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Zip | 71753-3412
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Country | US
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Telephone | 796-524-6304
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Fax |
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Provider Business Mailing Address
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Address Line | 712 W MAIN ST
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City | MAGNOLIA
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State | AR
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Zip | 71753-3412
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Country | US
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Telephone | 796-524-6304
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | E5489
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License Number State | AR
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