Provider Demographics
NPI:1689681652
Name:BEACHLER, SUSAN C (OD)
Entity Type:Individual
Prefix:DR
First Name:SUSAN
Middle Name:C
Last Name:BEACHLER
Suffix:
Gender:F
Credentials:OD
Other - Prefix:DR
Other - First Name:SUSAN
Other - Middle Name:C
Other - Last Name:BAILEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 875
Mailing Address - Street 2:
Mailing Address - City:CARTHAGE
Mailing Address - State:NC
Mailing Address - Zip Code:28327-0875
Mailing Address - Country:US
Mailing Address - Phone:910-947-7740
Mailing Address - Fax:910-947-7742
Practice Address - Street 1:101 MONROE PL
Practice Address - Street 2:
Practice Address - City:CARTHAGE
Practice Address - State:NC
Practice Address - Zip Code:28327-9784
Practice Address - Country:US
Practice Address - Phone:910-947-7740
Practice Address - Fax:910-947-7742
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1253152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8909950Medicaid
NC09950OtherBCBS
MW0106319OtherDEA
MW0106319OtherDEA
NC2190972BMedicare PIN