Provider Demographics
NPI:1003146622
Name:DAVID W. BEESON, O.D., P.C.
Entity Type:Organization
Organization Name:DAVID W. BEESON, O.D., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:W
Authorized Official - Last Name:BEESON
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:802-878-2633
Mailing Address - Street 1:863 HARVEST LN
Mailing Address - Street 2:P.O. BOX 1550
Mailing Address - City:WILLISTON
Mailing Address - State:VT
Mailing Address - Zip Code:05495-7319
Mailing Address - Country:US
Mailing Address - Phone:802-878-2633
Mailing Address - Fax:802-878-4636
Practice Address - Street 1:863 HARVEST LN
Practice Address - Street 2:
Practice Address - City:WILLISTON
Practice Address - State:VT
Practice Address - Zip Code:05495-7319
Practice Address - Country:US
Practice Address - Phone:802-878-2633
Practice Address - Fax:802-878-4636
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-04
Last Update Date:2010-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty