Provider Demographics
NPI:1669584140
Name:SCOTT, DAWN ANISE (OD)
Entity type:Individual
Prefix:DR
First Name:DAWN
Middle Name:ANISE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:313 SHARON DR
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15221-4029
Mailing Address - Country:US
Mailing Address - Phone:412-816-2272
Mailing Address - Fax:412-816-2275
Practice Address - Street 1:100 WALMART DR
Practice Address - Street 2:
Practice Address - City:NORTH VERSAILLES
Practice Address - State:PA
Practice Address - Zip Code:15137-1535
Practice Address - Country:US
Practice Address - Phone:412-816-2272
Practice Address - Fax:412-816-2275
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000432152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PASC1510796OtherBLUE CROSS GROUP NUMBER
PA01740116OtherMAID NUMBER
PA52936OtherDAVIS VISION
PA52936OtherDAVIS VISION
PAU57826Medicare UPIN
PASC1510796OtherBLUE CROSS GROUP NUMBER