Individual
DR. JAMES T. BEVERLY III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
635 PIO NONO AVE, MACON, GA 31204
(478) 803-0001
(478) 254-4997
Mailing address
635 PIO NONO AVE, MACON, GA 31204
(478) 803-0001
(478) 254-4997
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1471
GA
152WC0802X
Corneal and Contact Management Optometrist
1471
GA
152WL0500X
Low Vision Rehabilitation Optometrist
1471
GA
152WP0200X
Pediatric Optometrist
1471
GA
152WS0006X
Sports Vision Optometrist
1471
GA
152WV0400X
Vision Therapy Optometrist
1471
GA
152WX0102X
Occupational Vision Optometrist
1471
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000687981G
—
GA
Enumeration date
07/18/2006
Last updated
12/31/2009
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