Provider Demographics
NPI:1780776369
Name:NEUMAN, SCOTT CHARLES (OD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:CHARLES
Last Name:NEUMAN
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 1:819 W MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:RAWLINS
Mailing Address - State:WY
Mailing Address - Zip Code:82301-5462
Mailing Address - Country:US
Mailing Address - Phone:307-324-2219
Mailing Address - Fax:
Practice Address - Street 1:819 W MAPLE ST
Practice Address - Street 2:
Practice Address - City:RAWLINS
Practice Address - State:WY
Practice Address - Zip Code:82301-5462
Practice Address - Country:US
Practice Address - Phone:307-324-2219
Practice Address - Fax:307-324-7398
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY290T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY313114OtherBLUE CROSS BLUE SHIELD
WY120162000Medicaid
WYP00162043OtherRAILROAD MEDICARE
WY120162000Medicaid
WY5279160001Medicare NSC
WY10425Medicare PIN