Provider Demographics
NPI:1225889256
Name:BEAMON, GEORGE F
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:F
Last Name:BEAMON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2107 PYRAMID VILLAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27405-5100
Mailing Address - Country:US
Mailing Address - Phone:336-375-1239
Mailing Address - Fax:
Practice Address - Street 1:2107 PYRAMID VILLAGE BLVD
Practice Address - Street 2:
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27405-5100
Practice Address - Country:US
Practice Address - Phone:336-375-1239
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-28
Last Update Date:2024-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
156FX1800X
NC781156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician