MEDICARE: DR. BETHANY A HEATH O.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	02354	IA

General Provider Information

NPI Number	:	1043357692
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BETHANY A HEATH O.D.

Provider Business Mailing Address
First Line	:	1511 1ST AVE S
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-5012
Country	:	US
Telephone Number	:	515-955-7777
Fax Number	:	515-955-7082

Provider Business Practice Location Address
First Line	:	1511 1ST AVE S
Second Line	:
City	:	FORT DODGE
State	:	IA
Zip	:	50501-5012
Country	:	US
Telephone Number	:	515-955-7777
Fax Number	:	515-955-7082

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/31/2007
Last Update Date	:	06/06/2025

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