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Individual

SAMANTHA T. BEATY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
1310 EAST WALKER STREET, FULTON, MS 38843
(662) 862-6727
(662) 862-7969
Mailing address
1020 N GLOSTER ST STE 261, TUPELO, MS 38804-1202
(662) 269-4175
(662) 269-4176

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
668
MS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00880181
MS
Enumeration date
10/24/2006
Last updated
07/11/2022
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