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General NPI Number Information
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NPI Number | 1851354427
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Entity Type | Individual
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Provider Name | STACY LYNN SCROGGINS PA
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Gender | Female
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Dates
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Enumeration Date | 04/06/2006
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Last Update Date | 03/27/2025
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Provider Practice Location Address
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Address Line | 3101 ELKS ROAD
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City | MCALESTER
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State | OK
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Zip | 74501
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Country | US
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Telephone | 918-426-2442
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Fax | 918-423-4905
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Provider Business Mailing Address
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Address Line | 101 E. OKLAHOMA
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City | MCALESTER
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State | OK
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Zip | 74501
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Country | US
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Telephone | 918-423-4900
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Fax | 918-423-4905
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1066
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 1066
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License Number State | OK
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