Healthcare Provider Details

I. General information

NPI: 1083289888
Provider Name (Legal Business Name): BEECHER EYE CARE PLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/24/2021
Last Update Date: 06/22/2021
Certification Date: 06/22/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 S 16TH ST
CLARINDA IA
51632-2107
US

IV. Provider business mailing address

203 S 16TH ST
CLARINDA IA
51632-2107
US

V. Phone/Fax

Practice location:
  • Phone: 712-542-6521
  • Fax: 712-542-4209
Mailing address:
  • Phone: 712-542-6521
  • Fax: 712-542-4209

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. SCOTT RODNEY BEECHER
Title or Position: OPTOMETRIST
Credential:
Phone: 712-542-6521