Provider Demographics
NPI:1841282050
Name:BEECHER, SCOTT R (OD)
Entity type:Individual
Prefix:DR
First Name:SCOTT
Middle Name:R
Last Name:BEECHER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4600 SINGING HILLS BLVD
Mailing Address - Street 2:
Mailing Address - City:SIOUX CITY
Mailing Address - State:IA
Mailing Address - Zip Code:51106-9702
Mailing Address - Country:US
Mailing Address - Phone:712-271-4600
Mailing Address - Fax:712-271-4604
Practice Address - Street 1:4600 SINGING HILLS BLVD
Practice Address - Street 2:
Practice Address - City:SIOUX CITY
Practice Address - State:IA
Practice Address - Zip Code:51106-9702
Practice Address - Country:US
Practice Address - Phone:712-271-4600
Practice Address - Fax:712-271-4604
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAIA02151152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0198390Medicaid
IA1198390Medicaid
IA04491Medicare ID - Type Unspecified
IA1198390Medicaid
IA0198390Medicaid