Healthcare Provider Details

I. General information

NPI: 1437130176
Provider Name (Legal Business Name): SCOTT B MCCLAIN O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 03/13/2024
Certification Date: 03/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1025 W 6TH ST
JUNCTION CITY KS
66441-3230
US

IV. Provider business mailing address

2800 SW WANAMAKER RD SUITE 192
TOPEKA KS
66614-4293
US

V. Phone/Fax

Practice location:
  • Phone: 785-223-5777
  • Fax:
Mailing address:
  • Phone: 785-272-0707
  • Fax: 785-271-1512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberKS-1436
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: