Kyle Scott Bothwell
Kyle Scott Bothwell is an Optometry in Mesa, Arizona. Graduated from Southern College of Optometry in 2022, 4 years ago. Practices with Nationwide Optometry PC, a 55-clinician group and accepts Medicare assignment. Licensed in Arizona.
- Years since qualifying
- 4
- Trained at
- Southern College of Optometry
- Licensed in
- AZ
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
1240 W Southern Ave Ste 101Mesa, AZ 85202-4882
Phone: (480) 655-0741
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Optometrist (primary) | Taxonomy 152W00000X · Licence 002585 (AZ) |
|---|---|
| Pediatric Optometrist | Taxonomy 152WP0200X · Licence 002585 (AZ) |
Record details
| NPI number | 1912638115 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | June 20, 2022 |
| Last updated in NPPES | June 20, 2022 |
| Certification date | June 20, 2022 |
Medicare enrollment
| Medicare specialty | OPTOMETRY |
|---|---|
| Medical school | SOUTHERN COLLEGE OF OPTOMETRY |
| Graduated | 2022 (4 years in practice) |
| Group practice | Nationwide Optometry P.C. — 55 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |