Provider Demographics
NPI:1437234432
Name:HUSSING, SCOTT M (OD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:M
Last Name:HUSSING
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 1:646 PORTAGE TRL
Mailing Address - Street 2:
Mailing Address - City:CUYAHOGA FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44221-3034
Mailing Address - Country:US
Mailing Address - Phone:330-929-9941
Mailing Address - Fax:330-929-3926
Practice Address - Street 1:646 PORTAGE TRL
Practice Address - Street 2:
Practice Address - City:CUYAHOGA FALLS
Practice Address - State:OH
Practice Address - Zip Code:44221-3034
Practice Address - Country:US
Practice Address - Phone:330-929-9941
Practice Address - Fax:330-929-3926
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2013-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4111152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0361504Medicaid
OHT89094Medicare UPIN
OH0361504Medicaid