Provider Demographics
NPI:1962735324
Name:SCOTT, WHITNEY LANE (OD)
Entity type:Individual
Prefix:DR
First Name:WHITNEY
Middle Name:LANE
Last Name:SCOTT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:4600 W KELLOGG DR # L01
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67209-2568
Mailing Address - Country:US
Mailing Address - Phone:316-946-0105
Mailing Address - Fax:
Practice Address - Street 1:4600 W KELLOGG DR # L01
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209-2568
Practice Address - Country:US
Practice Address - Phone:316-946-0105
Practice Address - Fax:316-946-0145
Is Sole Proprietor?:No
Enumeration Date:2009-09-16
Last Update Date:2014-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1850152W00000X, 152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist