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Individual

DR. MATTHEW L SCOTT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
421 HWY 24 S, BUENA VISTA, CO 81211-3179
(719) 581-4060
(719) 631-2577
Mailing address
PO BOX 3179, BUENA VISTA, CO 81211-3179
(719) 581-4060
(719) 631-2577

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0003040
CO
152W00000X
Optometrist
1630
KS
152W00000X
Optometrist
2374
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100847010A
OK
05
21634378
CO
01
410049616
RR MEDICARE
OK
01
4706790001
DMERC
OK
01
P00278572
RAILROAD MEDICARE
OK
Enumeration date
06/21/2005
Last updated
06/04/2015
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