Healthcare Provider Details

I. General information

NPI: 1699722249
Provider Name (Legal Business Name): DIRK MICHAEL BEYER O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2006
Last Update Date: 03/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 W MAIN ST
HAMILTON MT
59840-2330
US

IV. Provider business mailing address

PO BOX 2068
HAMILTON MT
59840-4068
US

V. Phone/Fax

Practice location:
  • Phone: 406-363-2020
  • Fax: 406-363-0646
Mailing address:
  • Phone: 406-363-2020
  • Fax: 406-363-0646

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number634
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: