Individual
DR. DENNIS W BEZOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
2013 S JOPLIN AVE, JOPLIN, MO 64804-2033
(417) 624-5005
(417) 624-5215
Mailing address
2013 S JOPLIN AVE, JOPLIN, MO 64804-2033
(417) 624-8900
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
T02683
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
312283906
—
MO
01
—
32598
BCBS
MO
01
—
410016224
MEDICARE RAILROAD
MO
Enumeration date
06/14/2005
Last updated
01/24/2017
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