Provider Demographics
NPI:1649365651
Name:CARLE, SCOTT WF (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:WF
Last Name:CARLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 EDENFIELD CV
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72212-2667
Mailing Address - Country:US
Mailing Address - Phone:501-960-4137
Mailing Address - Fax:501-227-4542
Practice Address - Street 1:10101 MABELVALE PLAZA, STE 3
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205
Practice Address - Country:US
Practice Address - Phone:501-568-7868
Practice Address - Fax:501-568-3035
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARC65832083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR112158-001Medicaid
ARAC 261-5106OtherDEA NUMBER
ARC67949Medicare UPIN
50877Medicare ID - Type Unspecified
AR5G344Medicare PIN
AR112158-001Medicaid