person
Scott Stegall, PA-C
Medical Physician Assistant in Tyler, Texas
NPI 1356323034

Scott Stegall is a Medical Physician Assistant based in Dallas, TX and is specialized in Medical. Scott Stegall practices in Tyler, TX and has the professional credentials of PA-C. The NPI Number for Scott Stegall is 1356323034 and holds a License No. PA01268 (Texas).

The current practice location address for Scott Stegall is 5414 S Broadway Ave, Tyler, TX and can be reached out via phone at 903-581-1601 and via fax at 903-581-1638.

Location: 5414 S Broadway Ave, Tyler, TX, 75284-1656
person
Provider Profile Details
NPI Number
1356323034
Provider Name
Scott Stegall
Credential
PA-C
Provider Entity Type
Individual
Gender
Male
Address
5414 S Broadway Ave, Tyler, TX, 75284-1656
Phone Number
903-581-1601
Fax Number
903-581-1638
Provider Enumeration Date
11/17/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
8854MB 01 TX BCBS
8780MD 01 TX BCBS
337197303 05 TX
P01811994 01 TX RAIL ROAD MEDICARE
P01811499 01 TX RAIL ROAD MEDICARE
337197302 05 TX
institution
Provider Business Practice Location Address Details
Address
5414 S Broadway Ave
City
State
Zip
75703-1335
Phone Number
903-581-1601
Fax Number
903-581-1638
person
Provider Business Mailing Address Details
Address
5414 S Broadway Ave
City
State
Zip
75703-1335
Phone Number
903-581-1601
Fax Number
903-581-1638
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Physician Assistant
Speciality
Medical
Taxonomy
License No.
PA01268 (Texas)
Definition
Definition to come...
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