Individual
DR. EDWARD C BEITER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
100 WALMART DR, JACKSON, OH 45640-8692
(740) 288-2718
(740) 288-2720
Mailing address
11420 STATE ROUTE 776, JACKSON, OH 45640-8907
(740) 286-3100
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3054-352
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0428896
PCAN#
OH
Enumeration date
08/05/2006
Last updated
05/08/2008
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