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General NPI Number Information
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NPI Number | 1871763755
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Entity Type | Organization
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Legal Business Name | WILLIAM R BEYER JR, OD
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Dates
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Enumeration Date | 03/06/2008
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 395 HIGHWAY 33
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City | MERCERVILLE
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State | NJ
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Zip | 08619
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Country | US
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Telephone | 609-586-0273
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Fax | 609-586-7018
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Provider Business Mailing Address
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Address Line | 395 HIGHWAY 33
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City | MERCERVILLE
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State | NJ
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Zip | 08619
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Country | US
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Telephone | 609-586-0273
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Fax | 609-586-7018
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Authorized Official
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Title or Position | OWNER
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Name | WILLIAM R BEYER JR.
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Credential | OD
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Telephone | 609-586-0273
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 270A00411600
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 332H00000X
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Taxonomy Name | Eyewear Supplier
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License Number | 270A00411600
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License Number State | NJ
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