Provider Demographics
NPI:1750378998
Name:FOSTER, SCOTT E (OD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:E
Last Name:FOSTER
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 1:994 SW AYRSHIRE DR
Mailing Address - Street 2:
Mailing Address - City:LEES SUMMIT
Mailing Address - State:MO
Mailing Address - Zip Code:64081-2672
Mailing Address - Country:US
Mailing Address - Phone:816-519-0700
Mailing Address - Fax:816-554-0492
Practice Address - Street 1:994 SW AYRSHIRE DR
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64081-2672
Practice Address - Country:US
Practice Address - Phone:816-519-0700
Practice Address - Fax:816-554-0492
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-03
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOTO2524152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO312511306Medicaid
MO0414410001Medicare NSC
MOU08567Medicare UPIN
5840175Medicare PIN