Provider Demographics
NPI:1417160748
Name:DEAN B. SCOTT, OCULARIST
Entity Type:Organization
Organization Name:DEAN B. SCOTT, OCULARIST
Other - Org Name:DEAN B. SCOTT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MR
Authorized Official - First Name:DEAN
Authorized Official - Middle Name:
Authorized Official - Last Name:SCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:FCO
Authorized Official - Phone:941-388-4455
Mailing Address - Street 1:1319 BUTTERFIELD RD
Mailing Address - Street 2:SUITE 524
Mailing Address - City:DOWNERS GROVE
Mailing Address - State:IL
Mailing Address - Zip Code:60515-5601
Mailing Address - Country:US
Mailing Address - Phone:630-960-4455
Mailing Address - Fax:
Practice Address - Street 1:1901 S OSPREY AVE
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34239-3617
Practice Address - Country:US
Practice Address - Phone:941-388-4455
Practice Address - Fax:239-997-4455
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLM0548OtherBCBS ID
IL0670990OtherBC BS ID
FLM0548OtherBCBS ID