Provider Demographics
NPI:1245218916
Name:WEBB, SCOTT F (OD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:F
Last Name:WEBB
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:198 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:RUTLAND
Mailing Address - State:VT
Mailing Address - Zip Code:05701-3020
Mailing Address - Country:US
Mailing Address - Phone:802-775-2368
Mailing Address - Fax:802-775-2369
Practice Address - Street 1:198 N MAIN ST
Practice Address - Street 2:
Practice Address - City:RUTLAND
Practice Address - State:VT
Practice Address - Zip Code:05701-3020
Practice Address - Country:US
Practice Address - Phone:802-775-2368
Practice Address - Fax:802-775-2369
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2008-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT205152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT59631OtherMVP
VTWEBB00006621OtherBCBS
VT0006621Medicaid
VT0793130001Medicare NSC
VTWEBB00006621OtherBCBS
T25378Medicare UPIN