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General NPI Number Information
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NPI Number | 1770683757
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Entity Type | Individual
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Provider Name | SCOTT B WAYMENT OD
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Gender | Male
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Dates
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Enumeration Date | 09/22/2006
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Last Update Date | 06/18/2010
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Provider Practice Location Address
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Address Line | 1096 EASTLAND DR N STE 300
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City | TWIN FALLS
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State | ID
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Zip | 83301-8970
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Country | US
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Telephone | 208-733-7732
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Fax | 208-733-7733
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Provider Business Mailing Address
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Address Line | 1096 EASTLAND DR N STE 300
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City | TWIN FALLS
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State | ID
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Zip | 83301-8970
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Country | US
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Telephone | 208-733-7732
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Fax | 208-733-7733
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | ODP100012
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License Number State | ID
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