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General NPI Number Information
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NPI Number | 1932105467
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Entity Type | Individual
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Provider Name | MATTHEW L SCOTT O.D.
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Gender | Male
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Dates
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Enumeration Date | 06/21/2005
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Last Update Date | 06/04/2015
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Provider Practice Location Address
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Address Line | 421 HWY 24 S
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City | BUENA VISTA
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State | CO
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Zip | 81211-3179
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Country | US
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Telephone | 719-581-4060
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Fax | 719-631-2577
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Provider Business Mailing Address
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Address Line | PO BOX 3179
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City | BUENA VISTA
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State | CO
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Zip | 81211-3179
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Country | US
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Telephone | 719-581-4060
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Fax | 719-631-2577
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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 | 2374
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License Number State | OK
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1630
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License Number State | KS
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0003040
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License Number State | CO
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