Provider Demographics
NPI:1164824918
Name:BETH ANN ELSON-ESPOSITO, O.D. PLLC
Entity Type:Organization
Organization Name:BETH ANN ELSON-ESPOSITO, O.D. PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:BETH
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:ESPOSITO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:304-292-0669
Mailing Address - Street 1:7402 SCOTTSDALE RD
Mailing Address - Street 2:
Mailing Address - City:FAIRMONT
Mailing Address - State:WV
Mailing Address - Zip Code:26554-7808
Mailing Address - Country:US
Mailing Address - Phone:304-288-4399
Mailing Address - Fax:
Practice Address - Street 1:215 HORNBECK RD
Practice Address - Street 2:
Practice Address - City:MORGANTOWN
Practice Address - State:WV
Practice Address - Zip Code:26508-2476
Practice Address - Country:US
Practice Address - Phone:304-292-0669
Practice Address - Fax:304-292-0418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-09-24
Last Update Date:2014-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV933-OD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty