Provider Demographics
NPI:1639458979
Name:BARTLETT, SCOTT (OD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:
Last Name:BARTLETT
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 1:1245 E COLFAX AVE STE 303
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80218-2216
Mailing Address - Country:US
Mailing Address - Phone:303-861-2020
Mailing Address - Fax:720-729-8262
Practice Address - Street 1:3301 TOWER RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80011-3509
Practice Address - Country:US
Practice Address - Phone:303-307-0200
Practice Address - Fax:720-729-8262
Is Sole Proprietor?:No
Enumeration Date:2011-08-04
Last Update Date:2022-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM0650152W00000X
CA14218 TLG152W00000X
FLTPOP46152W00000X
WI21374-875152W00000X
CO3299152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM79137032Medicaid