Healthcare Provider Details

I. General information

NPI: 1316129125
Provider Name (Legal Business Name): DAWN A. SCOTT, O.D. & ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/04/2007
Last Update Date: 12/04/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 WALMART DR
NORTH VERSAILLES PA
15137-1535
US

IV. Provider business mailing address

100 WALMART DR
NORTH VERSAILLES PA
15137-1535
US

V. Phone/Fax

Practice location:
  • Phone: 412-816-2272
  • Fax: 412-816-2275
Mailing address:
  • Phone: 412-816-2272
  • Fax: 412-816-2275

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License NumberOEG000432
License Number StatePA

VIII. Authorized Official

Name: DR. DAWN ANISE SCOTT
Title or Position: OPTOMETRIST
Credential: O.D.
Phone: 412-816-2272