Provider Demographics
NPI:1912664574
Name:BELLAMY, WILLIAM HENRY (OD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:HENRY
Last Name:BELLAMY
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 1:240 RED MULBERRY WAY APT 4
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:WV
Mailing Address - Zip Code:25306-6322
Mailing Address - Country:US
Mailing Address - Phone:540-392-0155
Mailing Address - Fax:
Practice Address - Street 1:1301 LEE ST E # 1928
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:WV
Practice Address - Zip Code:25301-1928
Practice Address - Country:US
Practice Address - Phone:304-343-3363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV2085-IOD152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist