Provider Demographics
NPI:1912906876
Name:SCRUGGS, JENNIFER TREW (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:TREW
Last Name:SCRUGGS
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Gender:F
Credentials:MD
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Mailing Address - Street 1:9800 BAPTIST HEALTH DR
Mailing Address - Street 2:SUITE 600
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6229
Mailing Address - Country:US
Mailing Address - Phone:501-221-0123
Mailing Address - Fax:501-227-8859
Practice Address - Street 1:9800 BAPTIST HEALTH DR
Practice Address - Street 2:SUITE 600
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6229
Practice Address - Country:US
Practice Address - Phone:501-221-0123
Practice Address - Fax:501-227-8859
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2020-02-27
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Provider Licenses
StateLicense IDTaxonomies
ARE-8870207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARI13438Medicare UPIN