Provider Demographics
NPI:1740662725
Name:BEARD, LISA ERIN (OD, MS)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ERIN
Last Name:BEARD
Suffix:
Gender:F
Credentials:OD, MS
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Mailing Address - Street 1:510 BUTLER AVE
Mailing Address - Street 2:
Mailing Address - City:MARTINSBURG
Mailing Address - State:WV
Mailing Address - Zip Code:25405-9990
Mailing Address - Country:US
Mailing Address - Phone:304-263-0811
Mailing Address - Fax:304-579-2570
Practice Address - Street 1:510 BUTLER AVE
Practice Address - Street 2:
Practice Address - City:MARTINSBURG
Practice Address - State:WV
Practice Address - Zip Code:25405-9990
Practice Address - Country:US
Practice Address - Phone:304-263-0811
Practice Address - Fax:304-579-2570
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-25
Last Update Date:2018-01-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT2959152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist