Provider Demographics
NPI:1770683757
Name:WAYMENT, SCOTT B (OD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:B
Last Name:WAYMENT
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 1:1096 EASTLAND DR N STE 300
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-8970
Mailing Address - Country:US
Mailing Address - Phone:208-733-7732
Mailing Address - Fax:208-733-7733
Practice Address - Street 1:1096 EASTLAND DR N STE 300
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-8970
Practice Address - Country:US
Practice Address - Phone:208-733-7732
Practice Address - Fax:208-733-7733
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2010-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDODP100012152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
U95605Medicare UPIN
ID1594138Medicare ID - Type Unspecified