| Doctor Name: | DR. SCOT KENNETH CANFIELD |
| NPI Number: | 1104989862 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PHD,APN-BC |
| License Number: | 01765 |
| Business Practice Address: | 703 Calvin Avery Dr West Memphis, AR - 723016501 |
| Business Phone Number: | 8707321878 |
| Business Fax Number: | |
| Mailing Address: | 8863 Dewberry Ln, CORDOVA |
| State: | TN |
| Postal Code: | 380164010 |
| Phone Number: | 9017528773 |
| Fax Number: | |
| NPI Enumeration Date: | 12/17/2006 |
| NPI Last Update Date: | 02/16/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 364SP0807X |
| License Number: | 01765 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | AR |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Clinical Nurse Specialist |
| Taxonomy Specialization: | Psych/Mental Health, Child & Adolescent |
| Taxonomy Definition: | |