Provider Demographics
NPI:1831527639
Name:MATTHEWS, SCOTT (OD)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:
Last Name:MATTHEWS
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 1:316 S MCCASKEY RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTON
Mailing Address - State:NC
Mailing Address - Zip Code:27892-2150
Mailing Address - Country:US
Mailing Address - Phone:252-792-2250
Mailing Address - Fax:252-792-6293
Practice Address - Street 1:316 S MCCASKEY RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSTON
Practice Address - State:NC
Practice Address - Zip Code:27892-2150
Practice Address - Country:US
Practice Address - Phone:252-792-2250
Practice Address - Fax:252-792-6293
Is Sole Proprietor?:No
Enumeration Date:2013-10-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2338152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2338OtherSTATE LICENSE
NC2338OtherSTATE LICENSE