Provider Demographics
NPI:1497855084
Name:SEDLACEK, SCOTT LEONARD (OD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:LEONARD
Last Name:SEDLACEK
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 1:8099 COLUMBIA RD
Mailing Address - Street 2:
Mailing Address - City:OLMSTED FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44138-2021
Mailing Address - Country:US
Mailing Address - Phone:440-235-8099
Mailing Address - Fax:440-235-0222
Practice Address - Street 1:8099 COLUMBIA RD
Practice Address - Street 2:
Practice Address - City:OLMSTED FALLS
Practice Address - State:OH
Practice Address - Zip Code:44138-2021
Practice Address - Country:US
Practice Address - Phone:440-235-8099
Practice Address - Fax:440-235-0222
Is Sole Proprietor?:No
Enumeration Date:2006-09-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4990152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist