Provider Demographics
NPI:1740315936
Name:TREFTS, SCOTT A (OD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:A
Last Name:TREFTS
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 1:312 REDFERN VLG
Mailing Address - Street 2:
Mailing Address - City:ST SIMONS ISLAND
Mailing Address - State:GA
Mailing Address - Zip Code:31522-2522
Mailing Address - Country:US
Mailing Address - Phone:912-638-8652
Mailing Address - Fax:912-638-0490
Practice Address - Street 1:312 REDFERN VLG
Practice Address - Street 2:
Practice Address - City:ST SIMONS IS
Practice Address - State:GA
Practice Address - Zip Code:31522-2522
Practice Address - Country:US
Practice Address - Phone:912-638-8652
Practice Address - Fax:912-638-0490
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1881152W00000X
VA0618001641152W00000X
GA2639152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909293Medicaid
NC093NEOtherBLUECROSS
NC8909293Medicaid
NCU86586Medicare UPIN