Provider Demographics
NPI:1316442973
Name:VADALA, SCOTT ANDREW (MD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:ANDREW
Last Name:VADALA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:608 STANTON L YOUNG BLVD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73104-5065
Mailing Address - Country:US
Mailing Address - Phone:405-271-1095
Mailing Address - Fax:
Practice Address - Street 1:608 STANTON L YOUNG BLVD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73104-5065
Practice Address - Country:US
Practice Address - Phone:405-271-1095
Practice Address - Fax:405-271-1926
Is Sole Proprietor?:No
Enumeration Date:2018-03-27
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK39147207W00000X, 207WX0120X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0120XAllopathic & Osteopathic PhysiciansOphthalmologyCornea and External Diseases Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology