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General NPI Number Information
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NPI Number | 1962455352
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Entity Type | Organization
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Legal Business Name | EDWIN M SCHOTT OD PC
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Dates
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Enumeration Date | 05/18/2006
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Last Update Date | 12/20/2008
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Provider Practice Location Address
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Address Line | 21 WILLOW ST
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City | PORT ALLEGANY
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State | PA
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Zip | 16743-1334
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Country | US
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Telephone | 814-642-9408
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Fax | 814-642-9484
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Provider Business Mailing Address
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Address Line | 21 WILLOW ST
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City | PORT ALLEGANY
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State | PA
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Zip | 16743-1334
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Country | US
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Telephone | 814-642-9408
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Fax | 814-642-9484
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Authorized Official
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Title or Position | PRESIDENT
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Name | EDWIN SCHOTT
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Credential |
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Telephone | 814-642-9408
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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 | OEG001451
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License Number State | PA
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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 | OEG000103
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License Number State | PA
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