Individual
SCOTT RICHARD MARTIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
3625 RIGBY RD, MIAMISBURG, OH 45342-4981
(937) 247-2000
(937) 310-3021
Mailing address
1950 OLD GALLOWS RD STE 520, VIENNA, VA 22182-3970
(703) 847-8899
(571) 223-6780
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4954
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000281416
ANTHEM PROVIDER PIN
OH
Enumeration date
01/15/2007
Last updated
11/01/2023
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