Provider Demographics
NPI:1801853577
Name:INGLER, SCOTT D (OD)
Entity Type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:D
Last Name:INGLER
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:PO BOX 304
Mailing Address - Street 2:
Mailing Address - City:HAUBSTADT
Mailing Address - State:IN
Mailing Address - Zip Code:47639-0304
Mailing Address - Country:US
Mailing Address - Phone:812-768-6040
Mailing Address - Fax:
Practice Address - Street 1:800 E MULBERRY ST
Practice Address - Street 2:
Practice Address - City:FORT BRANCH
Practice Address - State:IN
Practice Address - Zip Code:47648-1644
Practice Address - Country:US
Practice Address - Phone:812-753-4991
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18003295A152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
V01468Medicare UPIN
NE278131Medicare ID - Type Unspecified