Organization
DR BEATTIE FORK UNION OFFICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RUSSELL WILLS BEATTIE JR. (OWNER)
(434) 842-3364
Entity
Organization
Contact information
Practice address
4321 JAMES MADISON HWY, SUITE 2, FORK UNION, VA 23055-2025
(434) 842-3364
(434) 842-3362
Mailing address
PO BOX 517, FORK UNION, VA 23055
(434) 842-3364
(434) 842-3362
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
022131
BLUE CROSS
—
Enumeration date
03/19/2007
Last updated
10/09/2007
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