DR. SCOTT DAVID FEDOSKY (NPI# 1710993654) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1710993654 |
| Entity Type | Individual |
| Full Name | DR. SCOTT DAVID FEDOSKY |
| Credential | MD |
| Practice Address |
2603 Main Dr Suite # 6 Fayetteville AR 72704-5278 |
| Practice Telephone | 4795714325 |
| Practice Fax Number | 4795714329 |
| Mailing Telephone | 4795714325 |
| Mailing Fax Number | 4795714329 |
| Enumeration Date | 2006-07-31 |
| Last Update Date | 2014-03-04 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | E 0546 | AR | Allopathic & Osteopathic Physicians |
| Street Address |
2603 MAIN DR SUITE # 6 |
| City | FAYETTEVILLE |
| State | AR |
| Zip Code | 72704-5278 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326321662 | Jennifer Mason | Physical Therapy Assistant | 2603 Main Dr, Suite 3, Fayetteville, AR 72704-5278 | 2011-09-22 |
| 1134441793 | Kim Kemery | Occupational Therapy Assistant | 2603 Main Dr, Suite 3, Fayetteville, AR 72704-5278 | 2010-02-24 |
| 1356582035 | Designing Health Pa | Family Medicine | 2603 Main Dr, Suite 6, Fayetteville, AR 72704-5278 | 2009-03-10 |
| 1538309646 | Kimberly Gasner | Physical Therapy Assistant | 2603 Main Dr, Suite 3, Fayetteville, AR 72704-5278 | 2009-03-02 |
| 1376789024 | Harris Physical Therapy, Pllc | Clinic/Center | 2603 Main Dr, Suite 3, Fayetteville, AR 72704-5278 | 2008-12-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598387037 | Anne-ashley Hull | Speech-Language Pathologist | 12905 Randolph Road, Fayetteville, AR 72704 | 2020-05-07 |
| 1427607019 | Destiny Bound, LLC | Midwife | 3825 N Salem Road, Fayetteville, AR 72704 | 2019-09-06 |
| 1043796881 | Travis Alexander | Physical Therapist | 3399 Black Forest Dr Ste 3, Fayetteville, AR 72704 | 2018-07-16 |
| 1104319433 | Rise Physical Therapy Pa | Clinic/Center | 3484 W Wedington Dr Ste 4, Fayetteville, AR 72704 | 2018-06-12 |
| 1346744232 | Wedington Dental, Pllc | Clinic/Center | 3500 Black Forest Drvie, Ste 1, Fayetteville, AR 72704 | 2018-03-23 |
| 1528410487 | Sharon Byrd | Licensed Practical Nurse | 17836 Harmon Rd, Fayetteville, AR 72704 | 2016-07-05 |
| 1861823502 | Andrea Warren | Pharmacist | 2875 W Martin Luther King Jr Blvd, Fayetteville, AR 72704 | 2013-12-05 |
| 1609157726 | Jessica Rose Collier | Speech-Language Pathologist | 2020 E Joyce Ave., Suite 2, Fayetteville, AR 72704 | 2011-09-02 |
| 1194044941 | Wcnc, Inc. | Skilled Nursing Facility | 4405 Persimmon Street, Fayetteville, AR 72704 | 2010-05-19 |
| 1841512944 | Jill K Johnston | Speech-Language Pathologist | 3472 N Sandpiper Dr, Fayetteville, AR 72704 | 2010-02-17 |
| Find all providers in zip 72704 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700297033 | Washington Regional Medical System | General Practice | 3 E. Appleby Road, Suite 101, Fayetteville, AR 72703 | 2014-05-08 |
| 1053754622 | Hessel Kooistra IIi | General Practice | 10971 Rocky Creek Rd, Fayetteville, AR 72701-0614 | 2013-04-12 |
| 1861636607 | John James Sacco | General Practice | 5018 Worthington Way, Fayetteville, NY 13066-8703 | 2009-04-23 |
| 1093877441 | Michael R Ressal | General Practice | 3415 C1 Melrose Road, Fayetteville, NC 28304-1608 | 2006-12-14 |
| 1184727711 | Donald Eric Milmore | General Practice | 120 Walnut Street, Fayetteville, NY 13066-2028 | 2006-09-07 |
| 1356377741 | Linda M Ekman | General Practice | 117 E Sycamore St, Fayetteville, AR 72703-2540 | 2006-06-25 |
| 1902832660 | Janet Lynn Titus | General Practice | 63 W Sunbridge Dr, Fayetteville, AR 72703-1825 | 2006-06-24 |
| 1720020712 | Diane Elizabeth Ashby | General Practice | 207 W Maple Ave, Fayetteville, WV 25840-1413 | 2006-06-12 |
| 1427008093 | Medical Associates of Northwest Arkansas Pa | General Practice | 1188 N Salem Rd Ste 6, Fayetteville, AR 72704-8803 | 2006-05-12 |
| 1164472908 | Johnny P Adkins | General Practice | 3053 N College Avenue, Fayetteville, AR 72703 | 2006-05-11 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 72704 |
Please comment or provide details below to improve the information on DR. SCOTT DAVID FEDOSKY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.