Individual
DR. SCOTT EDWARD SMALLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
2005019135
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
11505611
CAQH PROVIDER ID
—
05
—
1174534879
—
MO
05
—
317177806
—
MO
Enumeration date
08/10/2006
Last updated
07/09/2025
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