NPI 1003908237 · live from the CMS NPI Registry
Gary L. Beaver, O.D.
Optometrist in Independence, KS. National Provider Identifier 1003908237, active.
NPI record
| NPI | 1003908237 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Optometrist 152W00000X |
| Practice location | 300 W Laurel St, Independence, KS 67301 |
| Practice phone | 620-331-2112 |
| Mailing address | Po Box 47, Independence, KS 67301 |
| Enumerated | September 28, 2006 |
| Last updated | July 8, 2007 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Optometrist primary | 152W00000X | 1294-3 (KS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.