MEDICARE: DR. GREG M BEEM 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	609T	TN

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	410045419	OTHER	TN	RAILROAD MEDICARE ASHLAND CITY
2	410047739	OTHER	TN	RAILROAD MEDICARE NASHVILLE

General Provider Information

NPI Number	:	1417942343
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREG M BEEM O.D.

Provider Business Mailing Address
First Line	:	5505 EDMONDSON PIKE
Second Line	:	SUITE 101
City	:	NASHVILLE
State	:	TN
Zip	:	37211-5869
Country	:	US
Telephone Number	:	615-331-8688
Fax Number	:	615-331-2273

Provider Business Practice Location Address
First Line	:	5505 EDMONDSON PIKE
Second Line	:	SUITE 101
City	:	NASHVILLE
State	:	TN
Zip	:	37211-5869
Country	:	US
Telephone Number	:	615-331-8688
Fax Number	:	615-331-2273

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

Provider Enumeration Date	:	09/16/2005
Last Update Date	:	10/14/2014

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