Individual
DR. MATTHEW L SCOTT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
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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