MEDICARE: SCOT B. MORRIS O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2252	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013907773
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOT B. MORRIS O.D.

Provider Business Mailing Address
First Line	:	27122 MAIN ST STE 220
Second Line	:
City	:	CONIFER
State	:	CO
Zip	:	80433-8559
Country	:	US
Telephone Number	:	303-838-9165
Fax Number	:	303-816-7218

Provider Business Practice Location Address
First Line	:	27122 MAIN ST STE 220
Second Line	:
City	:	CONIFER
State	:	CO
Zip	:	80433-8559
Country	:	US
Telephone Number	:	303-838-9165
Fax Number	:	303-816-7218

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/25/2005
Last Update Date	:	08/26/2019

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