Individual
DR. SCOTT E MARTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1015 E DUPONT RD, FORT WAYNE, IN 46825-1553
(260) 416-0800
(260) 416-0999
Mailing address
1015 E DUPONT RD, FORT WAYNE, IN 46825-1553
(260) 416-0800
(260) 416-0999
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
18002594B
IN
152WC0802X
Corneal and Contact Management Optometrist
18002594B
IN
152WL0500X
Low Vision Rehabilitation Optometrist
18002594B
IN
152WX0102X
Occupational Vision Optometrist
Primary
18002594B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000089436
ANTHEM
IN
01
—
0786400001
DMERC
IN
Enumeration date
08/07/2006
Last updated
09/11/2025
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