Healthcare Provider Details

I. General information

NPI: 1770650228
Provider Name (Legal Business Name): GARY LEE BEST O.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 01/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

904 APPERSON DR
SALEM VA
24153-7135
US

IV. Provider business mailing address

904 APPERSON DR
SALEM VA
24153-7135
US

V. Phone/Fax

Practice location:
  • Phone: 540-389-0731
  • Fax:
Mailing address:
  • Phone: 540-389-0731
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152WC0802X
TaxonomyCorneal and Contact Management Optometrist
License Number0618001096
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: