Provider Demographics
NPI:1386219061
Name:BEAL, ABIGAIL SARAH (OD)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:SARAH
Last Name:BEAL
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:ABIGAIL
Other - Middle Name:SARAH BEAL
Other - Last Name:HILL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:9569 MENTOR AVE
Mailing Address - Street 2:
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-4521
Mailing Address - Country:US
Mailing Address - Phone:440-350-1344
Mailing Address - Fax:
Practice Address - Street 1:9569 MENTOR AVE
Practice Address - Street 2:
Practice Address - City:MENTOR
Practice Address - State:OH
Practice Address - Zip Code:44060-4521
Practice Address - Country:US
Practice Address - Phone:440-950-1344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-05-25
Last Update Date:2021-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOPT.006974152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHOPT.006974OtherOHIO VISION PROFESSIONALS BOARD