MEDICARE: SCOTT DAVID ANDERSON D.O.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	E4305	AR

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
10	P00288111	OTHER	AR	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00053	OTHER	AR	NOVASYS
2	05060015600	OTHER	AR	QUALCHOICE
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	7894121	OTHER	AR	AETNA
5	1991288	OTHER	AR	UNITED HEALTHCARE
6	3534376	OTHER	AR	CIGNA
7	5N206	OTHER	AR	HEALTH ADVANATAGE
8	5N206	OTHER	AR	ARKANSAS BLUE CROSS BLUE SHIELD
9	439393	OTHER	AR	HEALTHLINK

General Provider Information

NPI Number	:	1366403479
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT DAVID ANDERSON D.O.

Provider Business Mailing Address
First Line	:	128 HARMONY PARK CIRCLE, STE 100
Second Line	:
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913
Country	:	US
Telephone Number	:	501-881-4988
Fax Number	:	501-881-4755

Provider Business Practice Location Address
First Line	:	128 HARMONY PARK CIRCLE
Second Line	:	STE 100
City	:	HOT SPRINGS
State	:	AR
Zip	:	71913-7191
Country	:	US
Telephone Number	:	501-881-4988
Fax Number	:	501-881-4755

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/29/2006
Last Update Date	:	04/22/2022

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Directions to “ SCOTT DAVID ANDERSON D.O.” Practice Location

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