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Contact Information

MARK A BEACH, OD
1501 WAGNER AVE
GREENVILLE, OH45331-2763
 Phone: 937-547-9012
 Fax: 937-547-9361
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Optometrist

152W00000X 41 Optometry
Indicates primary specialty

NPI Profile & details for MARK A BEACH · (Male)

NPI Number 1487766630
Status Active
Credentials OD (Doctor of Optometry)
Entity Individual
Enumeration date 08/31/2006
Last updated 08/08/2008 - About 18 years ago
Sole proprietor 1 Yes
Identifiers
  • OH License # 4081/T348
  • OH Medicaid 2298393
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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