Provider Demographics
NPI:1033328307
Name:BEDIGREW, SCOTT DUANE (MS, ATC, CSCS)
Entity type:Individual
Prefix:MR
First Name:SCOTT
Middle Name:DUANE
Last Name:BEDIGREW
Suffix:
Gender:M
Credentials:MS, ATC, CSCS
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:2860 DALEWOOD TER
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73071-4708
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1809 STUBBEMAN AVE
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73069-8659
Practice Address - Country:US
Practice Address - Phone:405-366-5954
Practice Address - Fax:405-573-3590
Is Sole Proprietor?:No
Enumeration Date:2007-05-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKAT1302255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer