Provider Demographics
NPI:1992919054
Name:FEATHERSTON, JOHN SCOTT (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:SCOTT
Last Name:FEATHERSTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 HOLLYWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:HOT SPRINGS
Mailing Address - State:AR
Mailing Address - Zip Code:71901-7057
Mailing Address - Country:US
Mailing Address - Phone:501-321-9292
Mailing Address - Fax:501-623-5541
Practice Address - Street 1:100 HOLLYWOOD AVE
Practice Address - Street 2:
Practice Address - City:HOT SPRINGS
Practice Address - State:AR
Practice Address - Zip Code:71901-7057
Practice Address - Country:US
Practice Address - Phone:501-321-9292
Practice Address - Fax:501-623-5541
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARE-5154207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR189931003Medicaid
ARP01012415OtherTRAVELERS MEDICARE
AR5AL867252Medicare PIN
AR5AL86Medicare UPIN