Provider Demographics
NPI:1780641985
Name:SEIPEL, SCOTT H (OD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:H
Last Name:SEIPEL
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 1:3755 ORANGE PLACE
Mailing Address - Street 2:SUITE #101
Mailing Address - City:ORANGE VILLAGE
Mailing Address - State:OH
Mailing Address - Zip Code:44122-4455
Mailing Address - Country:US
Mailing Address - Phone:216-285-5133
Mailing Address - Fax:
Practice Address - Street 1:32730 WALKER RD BLDG J
Practice Address - Street 2:
Practice Address - City:AVON LAKE
Practice Address - State:OH
Practice Address - Zip Code:44012-4100
Practice Address - Country:US
Practice Address - Phone:440-455-3080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2017-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH3752T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0573964Medicaid
OHSE7349881Medicare PIN
OH0573964Medicaid