Provider Demographics
NPI:1912994799
Name:MCDONALD, SCOTT O (OD PA)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:O
Last Name:MCDONALD
Suffix:
Gender:M
Credentials:OD PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 HAYWOOD ROAD
Mailing Address - Street 2:SUITE A
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806
Mailing Address - Country:US
Mailing Address - Phone:828-254-1821
Mailing Address - Fax:828-251-9694
Practice Address - Street 1:1000 HAYWOOD ROAD
Practice Address - Street 2:SUITE A
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28806
Practice Address - Country:US
Practice Address - Phone:828-254-1821
Practice Address - Fax:828-251-9694
Is Sole Proprietor?:No
Enumeration Date:2005-10-05
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1306152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909593Medicaid
NC0387920001Medicare NSC
NC246628AMedicare PIN