Provider Demographics
NPI:1710095476
Name:DEMERS, SCOTT HULME (OD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:HULME
Last Name:DEMERS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:JAMES
Other - Middle Name:SCOTT
Other - Last Name:HULME
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:670 N MCCARRAN BLVD
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-4600
Mailing Address - Country:US
Mailing Address - Phone:775-358-1317
Mailing Address - Fax:775-355-7522
Practice Address - Street 1:670 N MCCARRAN BLVD
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-4600
Practice Address - Country:US
Practice Address - Phone:775-358-1317
Practice Address - Fax:775-355-7522
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV548152WC0802X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV1710095476OtherNPI
NV1649388794OtherBILLING NPI
NV1710095476Medicaid
NV6061070001Medicare NSC
NVV103328Medicare UPIN