Healthcare Provider Details

I. General information

NPI: 1558546499
Provider Name (Legal Business Name): SCOTT FOSTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/09/2008
Last Update Date: 09/05/2025
Certification Date: 09/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

994 SW AYRSHIRE DR
LEES SUMMIT MO
64081-2672
US

IV. Provider business mailing address

994 SW AYRSHIRE DR
LEES SUMMIT MO
64081-2672
US

V. Phone/Fax

Practice location:
  • Phone: 816-519-0700
  • Fax:
Mailing address:
  • Phone: 816-519-0700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT E FOSTER
Title or Position: OPTOMETRIST
Credential: OD
Phone: 816-519-0700