Basic Information
| Provider Information | |||||||||
| NPI: | 1982799094 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DOBSON | ||||||||
| FirstName: | SCOTT | ||||||||
| MiddleName: | WILLIAM | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | O.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9400 E HAMPDEN AVE STE 1 | ||||||||
| Address2: | |||||||||
| City: | DENVER | ||||||||
| State: | CO | ||||||||
| PostalCode: | 802315414 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7207481800 | ||||||||
| FaxNumber: | 7207486040 | ||||||||
| Practice Location | |||||||||
| Address1: | 1113 S ABILENE CT | ||||||||
| Address2: | |||||||||
| City: | AURORA | ||||||||
| State: | CO | ||||||||
| PostalCode: | 800123685 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3037559447 | ||||||||
| FaxNumber: | 3037552140 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/04/2006 | ||||||||
| LastUpdateDate: | 10/29/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 10/29/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 152W00000X | ODP-1023 | ID | N | Eye and Vision Services Providers | Optometrist | 152W00000X | 3469 | WA | N | Eye and Vision Services Providers | Optometrist | 152W00000X | 1995 | CO | Y | Eye and Vision Services Providers | Optometrist |
ID Information
| ID | Type | State | Issuer | Description | 220810 | 01 | CO | EYEMED | OTHER | 226106 | 01 | CO | CLARITY | OTHER | 49134 | 01 | CO | DAVIS VISION | OTHER | 743117694 | 01 | CO | SUPERIOR VISION | OTHER | 22826 | 01 | CO | AVESIS | OTHER | 23023 | 01 | CO | SPECTERA VISION | OTHER | 26127 | 01 | CO | MES | OTHER | 74-3117694 | 01 | CO | SUPERIOR | OTHER |