Basic Information
| Provider Information | |||||||||
| NPI: | 1386635159 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | SCOTT & CHRISTIE AND ASSOCIATES PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 105 BRANDT DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | CRANBERRY TWP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 160666412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247725420 | ||||||||
| FaxNumber: | 7247725423 | ||||||||
| Practice Location | |||||||||
| Address1: | 105 BRANDT DR | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | CRANBERRY TWP | ||||||||
| State: | PA | ||||||||
| PostalCode: | 160666412 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7247725420 | ||||||||
| FaxNumber: | 7247725423 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2005 | ||||||||
| LastUpdateDate: | 07/02/2008 | ||||||||
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| AuthorizedOfficialLastName: | CHRISTIE | ||||||||
| AuthorizedOfficialFirstName: | WILLIAM | ||||||||
| AuthorizedOfficialMiddleName: | CLARK | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 7247725420 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | N | 193200000X MULTI-SPECIALTY GROUP | Eye and Vision Services Providers | Optometrist | 207W00000X | MD037014E | PA | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Ophthalmology |
ID Information
| ID | Type | State | Issuer | Description | 609235 | 01 | HIGHMARK BLUE SHIELD | OTHER | 001605256 | 05 | PA | MEDICAID | CE1313 | 01 | PA | RAILROAD MEDICARE | OTHER |