SCOTT W HOMER OD

SHOPKO STORES OPERATING CO LLC

Dr SCOTT W HOMER OD is a male medical professional, specializing in Optometry. He graduated in 1985 from Pacific University - College Of Optometry.

Contact

SHOPKO STORES OPERATING CO LLC

800 E 17TH ST
IDAHO FALLS
ID
834046151

Tel: 2085223795

SCOTT W HOMER OD Information

Npi 1760433684
Pac Id 8729021225
Professional Enrollment Id I20050606000938
Last Name HOMER
First Name SCOTT
Middle Name W
Suffix
Gender M
Credential OD
Medical School Name PACIFIC UNIVERSITY - COLLEGE OF OPTOMETRY
Graduation Year 1985
Primary Specialty OPTOMETRY
Secondary Specialty 1
Secondary Specialty 2
Secondary Specialty 3
Secondary Specialty 4
All Secondary Specialties
Organization Legal Name SHOPKO STORES OPERATING CO LLC
Group Practice Pac Id 0749292639
Number Of Group Practice Members 124
Line 1 Street Address 800 E 17TH ST
Line 2 Street Address
Marker Of Address Line 2 Suppression
City IDAHO FALLS
State ID
Zip Code 834046151
Phone Number 2085223795
Hospital Affiliation Ccn 1
Hospital Affiliation Lbn 1
Hospital Affiliation Ccn 2
Hospital Affiliation Lbn 2
Hospital Affiliation Ccn 3
Hospital Affiliation Lbn 3
Hospital Affiliation Ccn 4
Hospital Affiliation Lbn 4
Hospital Affiliation Ccn 5
Hospital Affiliation Lbn 5
Professional Accepts Medicare Assignment Y

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