Provider Demographics
NPI:1215080882
Name:CALEODIS, SCOTT PANDEL (OD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:PANDEL
Last Name:CALEODIS
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 1:5759 PLANK DR
Mailing Address - Street 2:
Mailing Address - City:HILLIARD
Mailing Address - State:OH
Mailing Address - Zip Code:43026-7346
Mailing Address - Country:US
Mailing Address - Phone:614-527-8504
Mailing Address - Fax:
Practice Address - Street 1:1475 UPPER VALLEY PIKE
Practice Address - Street 2:SUITE 448
Practice Address - City:SPRINGFIELD
Practice Address - State:OH
Practice Address - Zip Code:45504-4047
Practice Address - Country:US
Practice Address - Phone:937-525-9266
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4981152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist