Individual
SCOTT A. EDMONDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000492
PA
152WC0802X
Corneal and Contact Management Optometrist
OEG000492
PA
152WL0500X
Low Vision Rehabilitation Optometrist
OEG000492
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0062266000
KEYSTONE
PA
01
—
1422835
AETNA
PA
01
—
159973
BLUE CROSS BLUE SHIELD
PA
Enumeration date
06/20/2006
Last updated
10/10/2008
Update your record
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