Provider Demographics
NPI:1518058817
Name:VISION CONSULTANTS PLLC
Entity Type:Organization
Organization Name:VISION CONSULTANTS PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:BRIAN
Authorized Official - Last Name:BERES
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:304-792-1480
Mailing Address - Street 1:PO BOX 116
Mailing Address - Street 2:
Mailing Address - City:LOGAN
Mailing Address - State:WV
Mailing Address - Zip Code:25601
Mailing Address - Country:US
Mailing Address - Phone:304-792-1480
Mailing Address - Fax:
Practice Address - Street 1:77 HOSPITAL DR
Practice Address - Street 2:SUITE 400
Practice Address - City:LOGAN
Practice Address - State:WV
Practice Address - Zip Code:25601-3451
Practice Address - Country:US
Practice Address - Phone:304-792-1480
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV20176207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV180045749OtherRR MEDICARE
562873OtherSTERLING LIFE
WV1802361001Medicaid
226977OtherCOVENTRY HEALT
WV001705979OtherBLUE CROSS BLUE SHIELD
226977OtherAVANTRA FREEDOM
WV180045749OtherRR MEDICARE
WVH21166Medicare UPIN